| [ Summary ] |
Trace elements can pass through a dialysis membrane bidirectionally during hemodialysis treatment by diffusion in relation to the concentration gradient between the dialysate and the blood. They enter the blood when their concentration in the dialysate is higher than that which is free form in the blood. In such situations, the intake becomes huge, because the blood is exposed to over 360 liters of dialysate per week, and acute or subacute intoxication from trace elements may develop in hemodialysis patients. Accordingly, it is of clinical importance to note that the levels of trace elements in dialysis water should be reduced to less than those set by safety standards considered adequate for water treatment. Because there are no standards for trace elements in dialysis water in Japan, we should use the AAMI (The Association for the Advancement of Medial Instrumentation) standards. In the case of trace elements not included in AAMI standards, we should produce tentative standards related to the tap water standards set by the Japanese Ministry of Welfare and Labor. On the other hand, some trace elements in the blood might be deficient in hemodialysis patients because of the removal through hemodialysis. Supplementation of deficient trace elements has been controversial. |