Aluminium intoxication in renal disease.
Aluminium intoxication in renal failure occurred over weeks or months when dialysis fluid or parenteral solutions were heavily contaminated and over many years when the main source was oral administration of aluminium-containing phosphate binders. Encephalopathy was common during subacute intoxication but in slow aluminium poisoning the main brunt was borne by the bones. However, in both tempos of intoxication several organs or systems were involved. Encephalopathy was usually accompanied by bone disease, bone disease by parathyroid suppression and both by anaemia. The heart and the lymphocytes are probably damaged by aluminium overload. Among the many questions left unanswered 15 years after the incrimination of aluminium as the cause of this multi-system illness are: (1) does low level aluminium overload in renal failure cause gradual deterioration in cerebral function? And, if so, (2) does it resemble Alzheimer's disease or a slow-onset version of dialysis encephalopathy? The evidence we review suggests that the answer to (1) is 'yes' and to (2) 'probably the latter'.
Kerr
D N
DN
Department of Medicine, Royal Postgraduate Medical School, London, UK.
Ward
M K
MK
Ellis
H A
HA
Simpson
W
W
Parkinson
I S
IS
D000535:Aluminum / Q000506:poisoning*; D000740:Anemia / Q000139:chemically induced; D001847:Bone Diseases / Q000139:chemically induced; D001927:Brain Diseases / Q000139:chemically induced; D015312:Hemodialysis Solutions / Q000009:adverse effects*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D009410:Nerve Degeneration / Q000187:drug effects; D010280:Parathyroid Glands / Q000187:drug effects
D015312:Hemodialysis Solutions; D000535:Aluminum