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4. Failure to adhere to AAMI hemodialysis water treatment standards has resulted <br /> in several deaths in the US in 1979 and 1993. AAMI standards should continue to <br /> be followed by all dialysis programs.4 <br /> 5. Individuals with CKD should be notified of the potential risk of fluoride <br /> exposure by providing information on the NKF website including a link to the <br /> report in brief of the NRC2 and the Kidney Health Australia position paper.3 <br /> The risk is likely greatest in areas with naturally high water flouride levels. <br /> 6. The NKF has no position on the optimal fluoridation of water. The oral <br /> health of people with CKD is of certainly of interest to the NKF,but balancing the <br /> overall benefits and risks of fluoride exposure is the primary concern. <br /> 7. The 1981 NKF position paper on fluoridation is outdated. The paper is <br /> withdrawn and will no longer be circulated, effective from the 10/06/07 NKF <br /> Board of Director's meeting. <br /> References <br /> 1. Johnson WJ, Easterling RE, Oreopoulos D,Parfitt AM, Port F, Taves DR. Position <br /> Paper on Fluoridation.National Kidney Foundation 1981 <br /> 2. NRC (National Research Council). 2006 Fluoride in Drinking Water: A Scientific <br /> Review of EPA's Standards. Washington, DC: National Academy Press <br /> 3. Ludlow M, Luxton G, Mathew T. Effects of fluoridation of community water supplies <br /> for people with chronic kidney disease.Nephrol Dial Transplant 2007; 22:2763-2767 <br /> 4. Association for the Advancement of Medical Instrumentation: Water treatment <br /> equipment for hemodialysis applications(ANSI/AAMI RD62:2006). Association for the <br /> Advancement of Medical Instrumentation, Arlington, VA, 2006. <br /> 5. Environmental Protection Agency(EPA). Safe Drinking Water Act Ammendment <br /> 1986. <br /> 6. PHS (Public Health Service) 1991. Review of Fluoride Benefits and Risks: Report of <br /> the Ad Hoc Subcommittee on Fluoride Committee of the Committee to coordinate <br /> environmental Health and Regulated Programs. Public Health Service,US Department of <br /> Health and Human Services, Washington, DC. <br /> 7.NRC (National Research Council). 1993. Health Effects of Ingested Fluoride. <br /> Washington, DC: National Academy Press. <br /> 8. U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With <br /> understanding and improving health and objectives for improving health. 2 vols. <br /> Washington, D.C. U.S. Government Printing Office,November 2000. <br />