Diagnosis and treatment of aluminium bone disease.
Aluminium accumulation in serum and tissues is a well-known complication in patients with chronic renal failure, and retention of the element in bone has been implicated in the pathogenesis of the so-called aluminium-related bone disease (ARBD). Regular serum aluminium monitoring remains mandatory to detect patients and centres at risk for aluminium intoxication. Early recognition of ARBD however requires a desferrioxamine (DFO) test in combination with a serum iPTH measurement. Definite diagnosis of ARBD is made by histological examination of a bone biopsy. Once ARBD has been identified DFO treatment should be initiated and all potential sources of aluminium exposure eliminated. In order to minimize the risk for DFO-related cerebral, auditory and visual side-effects, and siderophore-mediated opportunistic infections the chelator should be used at low doses (5 mg/kg) and administered widely spaced (once weekly) following well-defined strategies of administration.
D'Haese
P C
PC
Department of Nephrology/Hypertension, University of Antwerp, Belgium.
Couttenye
M M
MM
De Broe
M E
ME
D000535:Aluminum / Q000097:blood / Q000633:toxicity*; D001847:Bone Diseases / Q000175:diagnosis* / Q000628:therapy; D001842:Bone and Bones / Q000473:pathology; D003676:Deferoxamine; D006801:Humans; D010281:Parathyroid Hormone / Q000097:blood; D006435:Renal Dialysis / Q000009:adverse effects
D010281:Parathyroid Hormone; D000535:Aluminum; D003676:Deferoxamine