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Dialysate Water Aluminium — ESENeph MCQ

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ModerateHaemodialysisDialysate Water AluminiumESENeph

A 65-year-old man with CKD G5D on haemodialysis is found to have a serum aluminium of 60 mcg/L (elevated). He is not on aluminium-containing binders. He lives in an area with high water aluminium content. What is the source?

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Correct answer: B — Aluminium in the dialysate water supply

Dialysis patients can be exposed to aluminium through the dialysate water supply if water treatment is inadequate. Reverse osmosis and deionisation should remove aluminium to safe levels (<10 mcg/L in dialysate). The large volume of water patients are exposed to during haemodialysis (>300-500 L per session) means even small concentrations can lead to significant aluminium accumulation. Water quality monitoring per UKKA/ISO standards is essential.

Reference: UKKA 2019 – Haemodialysis Guideline; ISO 23500 – Water for Dialysis