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.
Department of Nephrology, London Hospital, United Kingdom.
P
P
Altmann
K C
KC
Butter
D
D
Plowman
D M
DM
Chaput de Saintonge
J
J
Cunningham
F P
FP
Marsh
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