Despite the well known fact that individuals with kidney disease are at much higher risk of fluoride toxicity than the general population, there has yet to be any attempt in the United States, or any other country that practices mass-scale water fluoridation to determine the prevalence of fluoride-related effects (e.g., skeletal fluorosis) among kidney patients. The failure to do this research is inexcusable when considering that the vulnerability of kidney patients has been known since the early 1940s, and fluoridation’s impact on kidney patients was a key concern expressed at the first congressional hearing on fluoridation in 1952. As a proponent of fluoridation, Dr. Heyroth, noted at the heairng:
“The question of the effect of water containing 1 p.p.m. upon patients with severe impairment of kidney function requires special consideration in view of the fact that radiologic evidence of chronic fluorosis has been found in two persons with severe kidney disease who died at the early ages of 22 and 23 years, respectively…”
SOURCE: Heyroth F. (1952). Hearings Before the House Select Committee to Investigate the Use of Chemicals in Foods and Cosmetics, House of Representatives, 82nd Congress, Part 3, Washington D.C., Government Printing Office, p. 28.
When asked by a congressional committee member: “Would you give fluoridated water to one with kidney trouble,” Dr. Heyroth responded: “No, the advice would be that he drink fluoride-free spring water.”
Over the past 60 years, evidence has continued to mount that kidney patients face a risk of skeletal fluorosis at low levels of exposure, and scientists have continued to express serious concerns about the harm fluoride might be causing a large number of people with kidney disease.
The following are excerpts from the scientific literature where scientists have highlighted the ongoing failure to systematically determine the safety of widespread fluoride exposure on kidney patients.
excerpts from scientific literature:
“[O]ur knowledge of the potential adverse effects of chronic low fluoride supplementation of drinking water on normal or diseased kidneys is insufficient. More than 60 years after water fluoridation, there is no high-level evidence as most published studies are small, have methological deficiencies or are otherwise flawed.”
SOURCE: Schiffl H. (2008). Fluoridation of drinking water and chronic kidney disease: absence of evidence is not evidence of absence. Nephrology Dialysis Transplantation 23:411.
“Specific recommendations regarding fluoride intake in CKD patients are not possible based on available limited data. . . . There are no randomized trials of fluoride exposure for individuals with CKD. Additional research on the risks and extent of fluoride exposure for the potentially susceptible population of CKD patients with impaired kidney function is recommended.”
SOURCE: National Kidney Foundation. Fluoride Intake in Chronic Kidney Disease. April 15, 2008. [See full statement]
“Information is particularly needed on fluoride plasma and bone concentrations in people with small-to-moderate changes in renal function as well as in those with serious renal deficiency.”
SOURCE: National Research Council. (2006). Fluoride in Drinking Water: A Scientific Review of EPA’s Standards. National Academies Press, Washington D.C. p 9.
“It would not be surprising if there were some undetected cases of skeletal fluorosis in the Australian population in individuals with pathological thirst disorders and/or impaired renal function. However, the matter has not been systematically examined. This matter should be the subject of careful and systematic review.”
SOURCE: National Health and Medical Research Council. (1991). The effectiveness of water fluoridation. Canberra, Australia: Australian Government Publishing Service.
“a fairly substantial body of research indicates that people with kidney dysfunction are at increased risk of developing some degree of skeletal fluorosis… However, there has been no systematic survey of people with impaired kidney function to determine how many actually suffer a degree of skeletal fluorosis that is clearly detrimental to their health.”
SOURCE: Hileman B. (1988). Fluoridation of water.Questions about health risks and benefits remain after more than 40 years. Chemical and Engineering News August 1, 1988, 26-42.
“In the United States, there have been no reported cases of skeletal fluorosis in persons who drink water containing only one part per million (ppm) of fluoride. However, since no systematic studies have been carried out in patients with renal insufficiency, this possibility cannot be excluded with certainty.”
SOURCE: Johnson W, et al. (1979). Fluoridation and bone disease in renal patients. In: E Johansen, DR Taves, TO Olsen, Eds. Continuing Evaluation of the Use of Fluorides. AAAS Selected Symposium. Westview Press, Boulder, Colorado. pp. 275-293.
“It seems probable that some people with severe or long-term renal disease, which might not be advanced enough to require hemodialysis, can still experience reduced fluoride excretion to an extent that can lead to fluorosis, or aggravate skeletal complications associated with kidney disease… It has been estimated that one in every 25 Americans may have some form of kidney disease; it would seem imperative that the magnitude of risk to such a large sub-segment of the population be determined through extensive and careful study. To date, however, no studies of this sort have been carried out, and none is planned.”
SOURCE: Groth, E. (1973). Two Issues of Science and Public Policy: Air Pollution Control in the San Francisco Bay Area, and Fluoridation of Community Water Supplies. Ph.D. Dissertation, Department of Biological Sciences, Stanford University, May 1973.
“It is generally agreed that water fluoridation is safe for persons with normal kidneys. Systemic fluorosis in patients with diminished renal function, however, seems a reasonable possibility. In such patients, fluoride may be retained with resulting higher tissue fluoride levels than in persons with normal renal function.”
SOURCE: Juncos LI, Donadio JV. (1972). Renal failure and fluorosis. Journal of the American Medical Association 222:783-5.
“All patients with dental fluorosis and anemia and/or signs of renal impairment should have radiographic examinations of the skeletal system to rule out the existence of fluoride osteosclerosis… It is likely that the reason our patient retained fluorine in his bones was that he had renal damage of long standing; without this the osteosclerosis might not have developed.”
SOURCE: Linsman JF, McMurray CA. (1943). Fluoride osteosclerosis from drinking water. Radiology 40: 474-484.
“The question of the effect of water containing 1 p.p.m. upon patients with severe impairment of kidney function requires special consideration in view of the fact that radiologic evidence of chronic fluorosis has been found in two persons with severe kidney disease who died at the early ages of 22 and 23 years, respectively…”
SOURCE: Heyroth F. (1952). Hearings Before the House Select Committee to Investigate the Use of Chemicals in Foods and Cosmetics, House of Representatives, 82nd Congress, Part 3, Washington D.C., Government Printing Office, p. 28.
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