title: Frequency of elevated serum aluminum levels in adult dialysis patients.
abstract: BACKGROUND
  Aluminum toxicity, a complication described in dialysis patients exposed to aluminum-containing phosphate binders or water used in dialysate preparations containing elevated levels of aluminum, can cause significant morbidity. Although physicians monitor patient aluminum levels, the frequency of abnormal aluminum levels has not been reported.
  
  
  METHODS
  We retrospectively examined 1,410 measurements of serum aluminum in 207 dialysis patients at the Franklin Dialysis Center (FDC; Philadelphia, PA) from January 1, 2000, through April 3, 2003. We also surveyed serum aluminum levels from a nationwide dialysis provider (DaVita) to more than 43,000 patients. Local dialysis facilities were surveyed to determine the annual frequency of aluminum testing in their patients.
  
  
  RESULTS
  Of 1,410 serum aluminum measurements performed at FDC, only 30 abnormal levels (2.1%) were found. DaVita measured approximately 117,000 aluminum levels annually during the last 3 years, of which 2.5% were abnormal. Frequencies of abnormal aluminum levels declined significantly each year at FDC and DaVita.
  
  
  CONCLUSIONS
  The current frequency of abnormal aluminum levels in our dialysis facility and a national dialysis provider is extremely low and has significantly declined.
authors.affiliation: Department of Medicine, Pennsylvania Hospital, Philadelphia, PA, USA.
authors.forename: Jared A
authors.initials: JA
authors.lastname: Jaffe
authors.forename: Carol
authors.initials: C
authors.lastname: Liftman
authors.forename: Joel D
authors.initials: JD
authors.lastname: Glickman
mesh_terms: D000535:Aluminum / Q000009:adverse effects / Q000097:blood*; D015331:Cohort Studies; D015312:Hemodialysis Solutions / Q000009:adverse effects; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D015143:Philadelphia / Q000453:epidemiology; D015995:Prevalence; D006435:Renal Dialysis; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
chemical_list: D015312:Hemodialysis Solutions; D000535:Aluminum