Original Paper

Trace Elements in Dialysis Fluids and Assessment of the Exposure of Patients on Regular Hemodialysis, Hemofiltration and Continuous Ambulatory Peritoneal Dialysis
P. Padovese^a, M. Gallieni^a, D. Brancaccio^a, R. Pietra^b, S. Fortaner^b, E. Sabbioni^b, C. Minoia^c, K. Markakis^a, A. Berlin<sup>d

a</sup>Renal Unit, Ospedale San Paolo, Milano;
^bCommission of the European Communities, Environment Institute, Life Sciences Unit, Joint Research Centre, Ispra Establishment, Ispra(VA);
^cIndustrial Hygiene Laboratory, Fondazione Clinica Lavoro, Pavia, Italy;
^dCommission of the European Communities, General Directorate for Employment, Industrial Relations and Social Affairs, Health and Safety Directorate (DG V), Luxembourg

Address of Corresponding Author

Nephron 1992;61:442-448 (DOI: 10.1159/000186964)

  Key Words

• Trace elements
• Uremia
• Dialysis fluids
• Dialysis
• Hemofiltration
• Continuous ambulatory peritoneal dialysis

  Abstract

Forty-four elements (Al, Sb, As, Ba, Be, B, Br, Cd, Ce, Co, Cr, Cs, Cu, Eu, Ga, Au, Hf, In, Ir, Fe, La, Lu, Mn, Hg, Mo, Nd, Ni, Pb, Rb, Sm, Sc, Se, Ag, Sr, Ta, Tb, Tl, Th, Sn, W, U, V, Zn, Zr) have been determined in the dialysate for hemodialysis (HD) and fluids for hemofiltration (HF) and continuous ambulatory peritoneal dialysis (CAPD). Multiple determinations have been performed for each dialysis fluid. Several trace elements (TE) showed remarkably elevated average levels; moreover, different bathes of the same commercial product may present a wide variability in TE concentration. The data point out the pivotal role of dialysis fluids in contributing to TE imbalance in dialysis patients and allow the assessment of the potential element exposure of patients on regular dialytic treatment. Patients on HD treatment would be exposed on a weekly basis to milligrams of Al, B, Ba, Br, Cu, Fe, Ni, Pb, Rb, Sr and Zn; on HF, the highest exposures are due to Al, B, Br, Fe, Pb and Zn; on CAPD to B, Br, Fe and Zn. The weekly exposure for several TE appears to be 50- to 12,000-fold higher than the corresponding values on the amount absorbed via the diet (HD: Au, Ba, Be, Ce, Ga, La, Sc, Ta, Th, V, Zr; HF: Be, Ce, Ta, Th, V, Zr; CAPD: Au, Be, Ce, Ga, V, Zr). Although the actual contamination could be markedly influenced by other factors, such as the chemical form of the element or its ability to bind carriers, our data on TE exposure from dialysis fluids can give an insight for further studies on TE imbalances in dialyzed patients.

Copyright © 1992 S. Karger AG, Basel

  Author Contacts

Diego Brancaccio, MD, Chief Renal Unit, Ospedale San Paolo, via A. di Rudini, 8, I-20142 Milano (Italy)

  Article Information

Accepted: August 23, 1991
Published online: December 11, 2008
Number of Print Pages : 7