Progressive dialysis encephalopathy from dialysate aluminum

Abstract
Progressive dialysis encephalopathy was observed as a frequent complication (eight of 34 patients) in a small hemodialysis unit. After the water used for dialysis was deionized, no further cases of encephalopathy developed in 29 patients. In the absence of other apparent changes in therapy, this significant difference in incidence (P<.005) is considered to be the result of reduction in unusually high water aluminum levels from 0.637 mg/liter to less than 0.001 mg/liter by use of a deionizer. (Arch Intern Med138:1375-1377, 1978)