Epidemic aluminum intoxication in hemodialysis patients traced to use of an aluminum pump.
This study was designed to identify the source, risk factors, and clinical consequences of an outbreak of aluminum intoxication in hemodialysis patients using case-control and cohort studies.
In 1991, a dialysis center in Pennsylvania [Dialysis Center A (DCA) ] identified a number of patients with elevated serum aluminum levels.
All patients receiving dialysis at DCA during January 1,1987 to March 26,1992 were involved in the study.
A case-patient was defined as any patient with a serum aluminum level =100 mug/liter after =5 dialysis sessions at DCA.
Fifty-nine case-patients were identified.
Risk factors for elevated serum aluminum levels were receipt of bicarbonate- (rather than acetate-) based dialysate, higher number of sessions using bicarbonate dialysis, receipt of acid concentrate (used in bicarbonate dialysis) passed through one of two electric pumps, and a greater number of sessions using this concentrate.
The electric pumps had an aluminum casing, casing cover, and impeller.
Elevated levels of aluminum were found in acid concentrate after passing through a pump.
Seizures and mental status changes requiring hospitalization were associated with aluminum exposure.
We found that epidemic aluminum intoxication was caused by the use of an electric pump with aluminum housing to deliver acid concentrate used in bicarbonate dialysis.
Mots-clés Pascal : Hémodialyse, Homme, Complication, Intoxication, Aluminium, Etiologie, Pompe électrique, Liquide dialyse, Contamination, Pennsylvanie, Etats Unis, Amérique du Nord, Amérique, Service hospitalier, Métal, Epuration extrarénale, Equipement biomédical
Mots-clés Pascal anglais : Hemodialysis, Human, Complication, Poisoning, Aluminium, Etiology, Electric pump, Dialysis fluid, Contamination, Pennsylvania, United States, North America, America, Hospital ward, Metal, Extrarenal dialysis, Biomedical equipment
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0463180
Code Inist : 002B27B03. Création : 01/03/1996.