PubMed · 1598927
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L A Trissel. 1992. Alternative interpretation for data.. https://pubmed.ncbi.nlm.nih.gov/1598927/
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Plasma silicon measurements have been obtained in patients with end-stage renal disease on chronic dialysis therapy. The mean +/- SE values for normal plasma silicon concentrations are .15 +/- .02 mg/L. All dialysis groups showed marked elevations in their plasma silicon that correlated with the silicon content of their respective dialysis fluids. The values of two different hemodialysis groups and a peritoneal dialysis group were 4.6 +/- .4, 2.5 +/- .2, and 1.9 +/- 1.2 mg/L, respectively. The silicon content of their respective dialysis fluids were 4.0 +/- .7, 0.5 +/- .4, and 0 +/- .1 mg/L. The ultrafiltrability of plasma silicon through Cuprophane membranes was 79 +/- 2%. Hemodialysis patients drinking high-silicon well water showed significantly higher plasma silicon levels than patients drinking lower silicon municipal water. It is concluded that use of dialysis fluid with elevated silicon levels and the consumption of water containing high concentrations of silicon are two important determinants of silicon levels in a dialysis population. We observed no overt effects of silicon accumulation on the health status of our dialysis patients.
The quality of water is more and more important in the polluted world of today. The nephrologist is with his patients a great consumer of water; water for dialysis should be of the highest quality as each maintenance dialysis patient uses up to 150 liters 3 times per week for years, in direct contact with his blood through a very thin dialysis membrane. Water may be polluted at the collection-, treatment- or distribution centers or locally at the place of consumption. Aluminum, chloramine, pesticides, copper, herbicides and many other substances as well as bacteria, may be found in water. For these reasons the nephrologist uses a series of devices to clean or purify the water before use in his dialysis unit: softeners, de-ionisators, reverse-osmosis, charcoal filters, ultraviolet irradiation, a.o. A correct water circuit is important as well, as dead spaces could cause bacterial contamination. The ultra pure water has to be mixed before use in the dialyzer, with a concentrated electrolyte solution. The author discusses all these different aspects of water treatment in the particular situation of hemodialysis.
Peritoneal dialysis was performed on 7 end-stage renal failure patients using an I-lactate-containing solution sterilized by ultrafiltration through polyamide filters. The patients tolerated the procedure well while their metabolic acidosis and azotemia improved.