Fernández Martín J L, Cannata J B
Servicio de Metabolismo Oseo y Mineral, Instituto Reina Sofía de Investigación, Hospital Central de Asturias, Universidad de Oviedo.
Nefrologia. 2000 Jul-Aug;20(4):342-7.
Aluminium contaminated dialysate is the most dangerous source of aluminium for dialysis patients. The aim of this study was to assess the aluminium content in the dialysis fluid in all the Spanish dialysis centres in 1999 and to compare the results with those obtained in previous studies. For this purpose, all the 275 Spanish centres were invited to participate, we measured the concentration of aluminium in the dialysis fluids in all of them. Aluminium was measured by atomic absorption spectrometry. Since 1988 our laboratory has participated in a external quality assessment scheme for aluminium measurement (University of Surrey) having a good performance (fig. 1). The aluminium concentration in the dialysis fluids were compared with the results obtained in other 2 cross sectional studies performed in 1990 and 1994 following the same methodology. The participating centres were 242 out of 275 (88%). The percentage of centres with a concentration of aluminium in the dialysis fluid lower than 2 micrograms/l has increased throughout the period of study (45% in 1990, 69.8% in 1994 and 81.8% in 1999, fig. 2). One important finding of the new study was the increment in the percentage of centres having undetectable aluminium (< 1 microgram/L) (22.9% in 1990, 41.2% in 1994 and 66.9% in 1999, fig. 3). The safety threshold of 1 microgram/L should be the goal for all the dialysis centres. By contrast, the percentage of centres with aluminium concentration greater than 10 micrograms/L (the old safety threshold to avoid aluminium exposure established by the European Union in 1986) did not show a relevant decrease from 1994 to 1999 (from 5.1% to 4.1% respectively). Taking into account the aluminium content, the quality of the dialysis fluid has improved during the last 10 years, although there is still a non negligible percentage of centres (4.1%) with high aluminium concentration in the dialysis fluid (> 10 micrograms/L).
铝污染的透析液是透析患者铝的最危险来源。本研究的目的是评估1999年西班牙所有透析中心透析液中的铝含量，并将结果与先前研究所得结果进行比较。为此，邀请了西班牙所有275个中心参与，我们测量了所有中心透析液中的铝浓度。铝通过原子吸收光谱法测量。自1988年以来，我们实验室一直参与铝测量的外部质量评估计划（萨里大学），表现良好（图1）。将透析液中的铝浓度与1990年和1994年按照相同方法进行的其他两项横断面研究所得结果进行比较。参与的中心有275个中的242个（88%）。在整个研究期间，透析液中铝浓度低于2微克/升的中心百分比有所增加（1990年为45%，1994年为69.8%，1999年为81.8%，图2）。这项新研究的一个重要发现是铝含量不可检测（<1微克/升）的中心百分比有所增加（1990年为22.9%，1994年为41.2%，1999年为66.9%，图3）。1微克/升的安全阈值应成为所有透析中心的目标。相比之下，铝浓度大于10微克/升（欧盟1986年设定的避免铝暴露的旧安全阈值）的中心百分比从1994年到1999年没有显著下降（分别从5.1%降至4.1%）。考虑到铝含量，在过去10年中透析液质量有所改善，尽管仍有不可忽视的百分比的中心（4.1%）透析液中铝浓度较高（>10微克/升）。
