[The causes, diagnosis and treatment of aluminum toxicity in patients with chronic renal failure undergoing dialysis].
To study the causes, diagnosis and treatment of aluminum toxicity in patients with chronic renal failure, the serum aluminum concentration was determined in 27 normal subjects, 28 patients of various kinds of diseases with normal renal function and 81 patients of chronic renal failure with hemodialysis in 65 and without in 16, of whom 41 patients were determined the aluminum concentration in the bone tissue. Clinical symptoms were carefully observed in all patients and desferrioxamine (DFO) test was performed in 17 patients, of whom 10 were treated with DFO. The results showed that treatment with improperly processed water and administration of aluminum compound were the major causes of aluminum toxicity in uremic patients. Aluminum toxicity may induce anemia, encephalopathy and bone disease, but its clinical features were nonspecific and the diagnosis may require several serum aluminum determinations or DFO test. DFO can chelate aluminum in a variety of tissues so that the latter may be released into the blood circulation. The DFO test may be used to assess the actual aluminum load in the bone tissue. The changes in serum aluminum concentration after intravenous infusion of DFO correlated closely with bone aluminum level, suggesting that the DFO test may be useful for the diagnosis of aluminum toxicity. The DFO therapy may be indicated for, 1, patients with uremia having hyperaluminumnemia due to treatment with improperly processed water and intake of aluminum-containing agents. 2. those who had serum aluminum concentration of higher than 200 micrograms/L and positive DFO test and 3. patients whose aluminum concentration in the bone tissue was 10 times greater than normal values. In this study, DFO was given intravenously in a dose of 20-40 mg/kg, twice a week. Satisfactory results were obtained in 3 to 6 months and there were no severe side effects when the agent was administered slowly.
Wang
G
G
Ruijin Hospital, Shanghai.
Zhu
P
P
Wang
S
S
D000535:Aluminum / Q000378:metabolism / Q000506:poisoning*; D001842:Bone and Bones / Q000378:metabolism; D003676:Deferoxamine / Q000627:therapeutic use*; D006801:Humans; D011041:Poisoning / Q000188:drug therapy / Q000378:metabolism; D006435:Renal Dialysis / Q000009:adverse effects*; D051437:Renal Insufficiency / Q000150:complications*; D017262:Siderophores / Q000627:therapeutic use*
D017262:Siderophores; D000535:Aluminum; D003676:Deferoxamine