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Acute nickel intoxication by dialysis

J D Webster, T F Parker, A C Alfrey

    Annals of Internal Medicine
    |May 1, 1980
    PubMed
    Summary
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    Dialysis patients experienced nickel intoxication due to contaminated dialysate from a nickel-plated water heater. Symptoms like nausea and vomiting resolved after dialysis, as nickel bound to plasma, hindering its removal.

    Area of Science:

    • Nephrology
    • Toxicology
    • Environmental Health

    Background:

    • Dialysis patients are susceptible to environmental toxins.
    • Nickel contamination in medical equipment can pose health risks.

    Purpose of the Study:

    • To investigate nickel intoxication in hemodialysis patients.
    • To identify the source and mechanism of nickel exposure during dialysis.

    Main Methods:

    • Observational study of 23 hemodialysis patients.
    • Analysis of dialysate and plasma nickel concentrations.
    • Clinical assessment of patient symptoms.

    Main Results:

    • Nickel leaching from a water heater tank contaminated dialysate.
    • Patients exhibited symptoms including nausea, vomiting, and weakness at plasma nickel levels of ~3 mg/L.

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  • Nickel bound to plasma, preventing efficient removal during dialysis.

    • Conclusions:

    • Nickel-plated stainless steel water heater tanks can be a source of nickel intoxication in dialysis patients.
    • Plasma binding of nickel impedes its clearance via hemodialysis.
    • Prompt identification and removal of the contamination source are crucial.