Progressive dialysis encephalopathy from dialysate aluminum

Area of Science:

• Nephrology
• Environmental Health Science

Background:

• Progressive dialysis encephalopathy is a serious complication of hemodialysis.
• High aluminum levels in water used for dialysis have been suspected as a cause.

Purpose of the Study:

• To investigate the link between water aluminum levels and dialysis encephalopathy.
• To assess the impact of water deionization on the incidence of this complication.

Main Methods:

• Observational study in a hemodialysis unit.
• Water quality analysis before and after deionization.
• Patient monitoring for neurological complications.

Main Results:

• Eight of 34 patients developed progressive dialysis encephalopathy.
• After deionization, water aluminum levels decreased from 0.637 mg/L to <0.001 mg/L.
• No further cases occurred in 29 patients post-deionization (P < .005).

Conclusions:

• Elevated aluminum in dialysis water is a significant risk factor for dialysis encephalopathy.
• Water deionization is an effective method to reduce aluminum levels and prevent this complication.
• This highlights the importance of water quality control in hemodialysis units.