The desferrioxamine test predicts bone aluminium burden induced by A1(OH)3 in uraemic patients but not mild histological osteomalacia.
Desferrioxamine (DFO), a chelating agent of aluminium was administered to 27 uraemic patients on chronic haemodialysis or haemofiltration with a minimal parenteral exposure to aluminium but taking various amounts of A1(OH)3 for about two years. All these patients had a double bone biopsy for measurement of their aluminium content and histomorphometric evaluation. Bone aluminium of our patients were 10 times greater than in our uraemic controls. Plasma aluminium increase (delta A1) induced by DFO correlated better than basal plasma aluminium with bone aluminium and cumulative dose of A1(OH)3 correlated with bone aluminium and delta A1 DFO. None of the patients had florid osteomalacia and only two had traces of aluminium staining. However 16 had mild mineralisation defect as demonstrated by low mineral appositional rate. The aluminium parameters were not different between the two groups of patients with or without mild mineralisation defect. It is concluded that the DFO test predicts bone aluminium but not mild histological osteomalacia in uraemic patients moderately aluminium over-loaded with phosphate binders.
D000368:Aged; D000535:Aluminum / Q000378:metabolism*; D000536:Aluminum Hydroxide / Q000009:adverse effects; D001842:Bone and Bones / Q000378:metabolism*; D003676:Deferoxamine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010018:Osteomalacia / Q000175:diagnosis; D014511:Uremia / Q000378:metabolism*
D000536:Aluminum Hydroxide; D000535:Aluminum; D003676:Deferoxamine