Effect of Water Deionisers on ‘Fracturing Osteodystrophy’ and Dialysis Encephalopathy in Plymouth

Abstract

In the Plymouth (England) area, 95 patients with end-stage renal failure underwent hemodialysis for 6 mo. or longer. Of the 47 patients beginning dialysis between 1967-1973, when water deionizers were not used routinely, a bone disease with multiple fractures, fracturing osteodystrophy, occurred in 18 patients and dialysis encephalopathy in 10. Of the 48 patients first dialysing between 1974-1979, when water deionizers were used commonly, fracturing osteodystrophy occurred in only 1 and dialysis encephalopathy also in only 1. Duration of dialysis without a water deionizer appeared to be the most important factor in the development of these 2 conditions. The use of water deionizers usually led to healing of fractures in patients with fracturing osteodystrophy, and to improvement in 4 of the 11 patients with dialysis encephalopathy. Neither condition has occurred in any patient using a water deionizer from the 1st dialysis. Water deionizers appeared to be effective in both the treatment and prevention of fracturing osteodystrophy and dialysis encephalopathy.