Evidence for a toxic effect of aluminum on osteoblasts: a histomorphometric study in hemodialysis patients with aplastic bone disease.
To evaluate the potential role of aluminum (Al) in a subset of dialysis patients with aplastic bone disease, we have studied tetracycline-labeled bone biopsies of 32 patients (22 males and 10 females, 45-73 years) on maintenance hemodialysis. Selection criteria included normal resorption surfaces (RS) and osteoid thickness. Eleven patients (Group I) had no stainable bone Al (Al-; 61.7 +/- 7.2 years) and 21 (Group II) had stainable bone Al (Al+; 57.7 +/- 6.8 years). Serum Al was normal to slightly elevated in Group I, but significantly higher in Group II (p less than 0.01). Al surfaces (AlS), undetectable in Group I, were 67.8 +/- 17.9% in Group II. Bone Al content (BAC) was much lower in Group I than in Group II (14.8 +/- 3.7 vs. 113.8 +/- 100.2 micrograms/g, p less than 0.01), but higher in Group I than in controls (p less than 0.05). Extensive thin osteoid seams were present in Group II. AlS was correlated with OS (r = 0.56, p less than 0.001) and OV (r = 0.48, p less than 0.01). Labeled surfaces were decreased in both groups. Labeled osteoid surfaces (TLS/OS) were below 2 SD of the mean control values in 96% of patients and calcification rate (CR) was depressed below 0.20 micros/day in 44% of patients. Bone formation rate (BFR) was strikingly depressed, values being below one SD of the mean control value in 92-100% of patients at both levels and below 2 SD of the mean in 82% of patients at BMU levels. Mineralization lag time (OMP) was markedly prolonged above 2 SD of controls in 89% of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Parisien
M
M
Columbia University, College of Physicians and Surgeons, New York, NY 10032.
Charhon
S A
SA
Arlot
M
M
Mainetti
E
E
Chavassieux
P
P
Chapuy
M C
MC
Meunier
P J
PJ
D000368:Aged; D000535:Aluminum / Q000032:analysis / Q000097:blood / Q000633:toxicity*; D001706:Biopsy; D001847:Bone Diseases / Q000209:etiology / Q000473:pathology*; D001842:Bone and Bones / Q000473:pathology; D002118:Calcium / Q000097:blood; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D007085:Ilium / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010006:Osteoblasts / Q000166:cytology* / Q000187:drug effects; D010281:Parathyroid Hormone / Q000097:blood; D006435:Renal Dialysis / Q000009:adverse effects*
D010281:Parathyroid Hormone; D005293:Ferritins; D000535:Aluminum; D002118:Calcium