Residual renal function in hemodialysis patients may protect against hyperaluminemia.
We investigated 106 home hemodialysis patients whose mean [+/- SEM] serum aluminum (Al) concentration was 60.9 +/- 4.1 micrograms/liter. Serum Al concentration was inversely related to daily urine output (r = -0.52, P less than 0.001). Urine volume and measurements of Al exposure were included in a multivariate analysis of serum Al concentration in the 62 patients whose urine output was greater than 10 ml/day. The multiple correlation coefficient (r) was 0.70 (P less than 0.001) and the percentage contributions to r2 (indicating the relative importance of each factor) were: urine output 57%, oral Al intake 36%, total dialysis hours 7%. The additional contribution from cumulative water Al was negligible. In a subgroup of 26 patients with a urine output exceeding 10 ml/day, urinary Al excretion averaged 15.4 micrograms/day, and renal Al clearance and serum Al concentration were inversely related (r = -0.69, P less than 0.001). We conclude that Al-containing phosphate binders were a more important source of Al than was dialysate in these patients and that residual renal function can reduce the severity of hyperaluminemia in hemodialysis patients.
Altmann
P
P
Department of Nephrology, London Hospital, United Kingdom.
Butter
K C
KC
Plowman
D
D
Chaput de Saintonge
D M
DM
Cunningham
J
J
Marsh
F P
FP
D000328:Adult; D000535:Aluminum / Q000097:blood*; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006437:Hemodialysis, Home; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D014563:Urodynamics
D003404:Creatinine; D000535:Aluminum