Why do aluminum analyses?
(Oct) 26:670-673 1997
This review paper by Rosenthal expresses the opinion (without any hard data),
that dialysis center water should be tested for aluminum frequently. AAMI
annual testing; Dr. Rosenthal suggests it should be done quarterly.
He cites several case reports where elevated aluminum levels were found.
In one center, a cluster of patients was found to have high serum aluminum
(20-30 µg/L). The cause was addition of alum to the source water by
local water authority, to assist in precipitating particulate matter (this
became necessary after recent drought conditions). Dr. Rosenthal points out
his experience (again without denominators it is difficult to understand the
importance of the effect), on at least 9 separate occasions, center wide
aluminum contamination of dialysis center water systems occurred. Causes
|Causes of center-wide contamination of water with aluminum|
|Alum added to water supply (most frequent)|
|Torn RO membrane; failure to monitor RO rejection ratio|
|Micropuncture of RO membrane by CaCO3 crystals; softener depleted of
|Failure to turn RO system back on after servicing|
|Presence of aluminum component or contaminant in dialysis system
He also discusses other chemical contaminants, notably fluoride, although the
discussion is not
developed in great detail.
Comment: I believe that AAMI is proposing revised standards now, which
are open for comment.
You can reach the AAMI site at
Unfortunately, most AAMI documents are not available via the Web. They can
be purchased for an
exorbitant price as a CD-ROM ($1100.00!!).
(John T. Daugirdas, M.D., University of Illinois at Chicago)