Hard water syndrome

A unique set of circumstances was responsible for symptoms resembling hard water syndrome [64] followed by an epidemic of acute Al encephalopathy in a dialysis unit (Diatel) on the island of Curasao. A tragic coincidence is that the intoxication happened about two months before the planned installation of a water treatment system with deionization and reverse osmosis (RO). Traditionally, municipal water had been used for more than two decades without extended purification for the production of dialysate. The pure... 

This syndrome is often seen after hemodialysis and may last throughout the following day. It occurs mostly in elderly or debilitated patients who feel weak, washed out, and are hardly functional after dialysis. It has been suggested that the symptoms are caused by interleukin-1 released from activated monocytes (B22). More likely, however, the syndrome is related to water and electrolyte fluxes and the cardiovascular stress associated with hemodialysis. 

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