On the basis of the available evidence, Kidney Health Australia has developed the following position statement regarding fluoridation of community water supplies:
There is no evidence that consumption of optimally fluoridated drinking water increases the risk of developing CKD, although only limited studies addressing this issue are available
There is consistent evidence that impairment of kidney function results in changes to the way in which fluoride is metabolized and eliminated from the body, resulting in an increased burden of fluoride
There is no evidence that consumption of optimally fluoridated drinking water poses any health risks for people with CKD, although only limited studies addressing this issue are available
There is limited evidence that people with stage 4 or 5 CKD who ingest substances with a high concentration of fluoride may be at risk of fluorosis
Monitoring of fluoride intake and avoidance of fluoride-rich substances would be prudent for people with stage 4 or 5 CKD, in addition to regular investigations for possible signs of fluorosis
Fluoride concentrations in the final feed water to the dialysis machine must comply with established water quality guidelines.
Effects of fluoridation of community water supplies for people with chronic kidney disease Marie Ludlow, Grant Luxton, and Timothy Mathew Nephrology Dialysis Transplantation