title: Infant formula as a cause of aluminium toxicity in neonatal uraemia.
abstract: Aluminium toxicity occurred in two infants with congenital uraemia who had never received phosphate binders or other aluminium-containing agents or intravenous fluids. One patient was treated by peritoneal dialysis from the age of two weeks and died at three months after the sudden onset of neurological symptoms; the other died after one month of conservative management without dialysis. Brain aluminium concentration was high in both infants (6.4 and 47 micrograms/g, respectively) whereas bone aluminium content was normal and there were no histological changes or stainable aluminium on bone biopsy specimens. Both infants were fed with 'Similac PM 60/40'. To investigate possible sources of aluminium, powdered milk formula, sterilised water used for preparation of the feed, and dialysate concentrate (first patient) were analysed. Aluminium concentration was high (232 +/- 60 ng/ml) in powdered milk but negligible in sterilised water and dialysate concentrate (4 ng/ml and 3.4 +/- 2.4 ng/ml, respectively). These findings indicate that proprietary infant milk formula is another source of aluminium. Aluminium-free milk should contribute to the prevention of aluminium toxicity in infants with renal failure.
authors.forename: M
authors.initials: M
authors.lastname: Freundlich
authors.forename: G
authors.initials: G
authors.lastname: Zilleruelo
authors.forename: C
authors.initials: C
authors.lastname: Abitbol
authors.forename: J
authors.initials: J
authors.lastname: Strauss
authors.forename: M C
authors.initials: MC
authors.lastname: Faugere
authors.forename: H H
authors.initials: HH
authors.lastname: Malluche
mesh_terms: D000535:Aluminum / Q000032:analysis / Q000506:poisoning*; D001842:Bone and Bones / Q000032:analysis; D001923:Brain Chemistry; D005260:Female; D006801:Humans; D007223:Infant; D007225:Infant Food / Q000009:adverse effects* / Q000032:analysis; D007231:Infant, Newborn; D007668:Kidney / Q000002:abnormalities; D014511:Uremia / Q000209:etiology / Q000378:metabolism*
chemical_list: D000535:Aluminum