Silicon accumulation in dialysis patients.

Area of Science:

• Nephrology
• Clinical Chemistry
• Environmental Health

Background:

• End-stage renal disease (ESRD) patients on chronic dialysis therapy are susceptible to altered mineral metabolism.
• Silicon is an element present in water and medical supplies, with potential implications for patients with impaired renal function.

Purpose of the Study:

• To investigate plasma silicon concentrations in patients with ESRD undergoing chronic dialysis.
• To identify sources and determinants of elevated silicon levels in this patient population.
• To assess the health impact of silicon accumulation in dialysis patients.

Main Methods:

• Measurement of plasma silicon concentrations in ESRD patients across different dialysis modalities (hemodialysis and peritoneal dialysis).
• Analysis of silicon content in dialysis fluids and patient-consumed water sources (well water vs. municipal water).
• Assessment of plasma silicon ultrafiltrability through dialysis membranes (Cuprophane).

Main Results:

• Dialysis patients exhibited significantly elevated plasma silicon levels compared to normal concentrations (0.15 +/- 0.02 mg/L).
• Plasma silicon levels strongly correlated with the silicon content of dialysis fluids used.
• Hemodialysis patients consuming high-silicon well water had higher plasma silicon than those on lower-silicon municipal water.
• Silicon ultrafiltrability through Cuprophane membranes was 79 +/- 2%.

Conclusions:

• Elevated silicon levels in dialysis fluids and high-silicon water consumption are key factors contributing to silicon accumulation in dialysis patients.
• No overt adverse health effects were observed in the studied dialysis patients despite elevated silicon levels.