Assessment of Aluminum, Barium, and Copper Levels in the Blood of Hemodialysis Patients in Ramadi City, Anbar Governorate, Iraq

In addition to the lack of kidney function, patients on regular hemodialysis are exposed to trace and heavy metals in the dialysate water, dialysis equipment, and medications. This chronic exposure poses significant health issues for this at-risk population. The aim of the present study was to assess the concentration of Al, Ba and Cu in the blood of 60 hemodialysis patients in the dialysis center of Ramadi city, Anbar governorate, Iraq, and to compare it with 60 age- and sex-matched healthy controls. Whole-blood samples were analysed for the concentration of each element using Graphite Furnace Atomic Absorption Spectrophotometry (GFAAS). The findings showed a statistically significant rise in the concentration of all three elements in the hemodialysis patients than in the control group, which was aluminum (18.45 \(\pm\) 1.512 vs 9.250 \(\pm\) 0.886 \(\mu\)g/L, P < 0.001), barium (15.46 \(\pm\) 1.231 vs 2.986 \(\pm\) 0.409 \(\mu\)g/L, P < 0.001) and copper (25.59 \(\pm\) 1.906 vs 14.16 \(\pm\) 0.688 \(\mu\)g/L, P < 0.001). A weak but statistically significant positive correlation was established between the aluminum level and barium level in the patients' group (r = 0.3179 and P = 0.0133), and no significant correlation was observed between the aluminum and copper levels and between the barium and copper levels. Although the aluminum level remained below the generally accepted safe limit for hemodialysis patients (< 60 \(\mu\)g/L), these results suggest that patients under hemodialysis are a population with a high risk for accumulation of trace elements and support the need for periodic biomonitoring of trace elements and improved quality control of dialysate water.