Acute Nickel Intoxication by Dialysis

  1. JAMES D. WEBSTER, M.D.;
  2. THOMAS F. PARKER, B.S. M.D.;
  3. AL C. ALFREY, M.D.;
  4. W. R. SMYTHE, Ph.D.;
  5. HIDEO KUBO, Ph.D.;
  6. GEORGE NEAL; and
  7. ALAN R. HULL, M.D.
  1. Dallas, Texas; and Denver, Colorado

    Abstract

    Nickel intoxication was observed in a group of 23 dialyzed patients when leaching of nickel-plated stainless steel water heater tank contaminated the dialysate. Symptoms occurred during and after dialysis at plasma nickel concentrations of approximately 3 mg/L. Symptoms included nausea (37 of 37), vomiting (31 of 37), weakness (29 of 37), headache (22 of 37), and palpitation (two of 37). Remission of symptoms occurred spontaneously, generally 3 to 13 hours after cessation of dialysis. The evidence indicated that the nickel became bound in the plasma after crossing the membrane, resulting in a higher concentration in the plasma than in the dialysate and preventing its removal by dialysis.

    Article and Author Information

    • ▸From the Abilene Dialysis Center, Abilene, Texas, the Dallas Kidney Disease Center, Dallas, Texas; the Veterans Administration Hospital, Denver, Colorado; the University of Colorado at Boulder, Boulder, Colorado; and National Medical Care, Boston, Massachusetts.

    • Grant support: from the National Institute of Arthritis, Metabolism, and Digestive Diseases.

    • ▸Requests for reprints should be addressed to Thomas F. Parker, M.D.; Dallas Kidney Disease Center, 3604 Live Oak; Dallas, TX 75204

      • Received September 10, 1979.
      • Received January 24, 1980.
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    This Article

    1. Ann Intern Med May 1, 1980 vol. 92 no. 5 631-633
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