title: Role of medication in the level of aluminium in the blood of chronic haemodialysis patients.
abstract: BACKGROUND
  Although dialysis facilities provide high-quality water, abnormal aluminium levels among patients on haemodialysis have still been reported. Since patients with chronic kidney disease are often on multiple medications, medicines may be an extra source of aluminium for them. The degree to which ingesting contaminated medication influenced the level of aluminium in the patients' blood was investigated.
  
  
  METHODS
  All medications consumed by a group of patients on regular dialysis treatment were analysed and the total aluminium ingested by each patient was calculated. At the same time, the patients' blood was collected and aluminium was measured. The analyses were carried out by atomic absorption spectrometry.
  
  
  RESULTS
  For all drugs consumed, the amount of aluminium ingested versus the blood aluminium level presented no correlation. Since a high level of contamination was presented by injectable iron, insulin and erythropoietin (EPO), another group of patients that received a reduced amount of oral medication was selected. Among them, eight did not receive any injectable drug, five received only EPO and seven injectable iron, EPO and insulin. With these restricted groups, it was possible to show that the injectable administration of contaminated medication increased the Al level in the patients' blood, mainly in relation to iron formulations.
  
  
  CONCLUSIONS
  Among the medications investigated, the injectables are the most significant source of aluminium for patients with renal insufficiency. This extra aluminium intake is reflected in higher aluminium levels in the patients' blood.
authors.affiliation: Department of Chemistry, Federal University of Santa Maria, 97110-905 Santa Maria, RS, Brazil. ndenise@quimica.ufsm.br
authors.forename: Denise
authors.initials: D
authors.lastname: Bohrer
authors.forename: Denise C
authors.initials: DC
authors.lastname: Bertagnolli
authors.forename: Sandra M R
authors.initials: SM
authors.lastname: de Oliveira
authors.forename: Paulo C
authors.initials: PC
authors.lastname: do Nascimento
authors.forename: Leandro M
authors.initials: LM
authors.lastname: de Carvalho
authors.forename: Solange C
authors.initials: SC
authors.lastname: Garcia
authors.forename: Luiz C
authors.initials: LC
authors.lastname: Arantes
authors.forename: Elvino J G
authors.initials: EJ
authors.lastname: Barros
mesh_terms: D000535:Aluminum / Q000097:blood*; D004340:Drug Contamination; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D006435:Renal Dialysis
chemical_list: D000535:Aluminum