Aluminum toxicity in neonatal parenteral nutrition: what can we do?
Aluminum toxicity has been described in patients of all ages who are receiving a variety of therapies, including dialysis, phosphate-binding medications, and parenteral nutrition (PN). Neonates are at an increased risk of aluminum toxicity because of anatomic, physiologic, and nutrition-related factors not present in other populations. In 2004, the Food and Drug Administration recommended restricting daily aluminum administration to 5 μg/kg/day and now requires that additives used to compound PN have the maximum aluminum content at expiration listed on the product label. Although the pharmacist can work to decrease aluminum toxicity in this population, it remains difficult to reach this threshold.
Centennial Medical Center, Nashville, TN, USA. Heather.Wier@hcahealthcare.com
Heather Ann
HA
Wier
Robert J
RJ
Kuhn
D000535:Aluminum / Q000032:analysis / Q000633:toxicity*; D003257:Consumer Product Safety; D004348:Drug Labeling / Q000331:legislation & jurisprudence; D006801:Humans; D007231:Infant, Newborn; D010288:Parenteral Nutrition / Q000592:standards*; D057947:Parenteral Nutrition Solutions / Q000737:chemistry* / Q000592:standards*; D014481:United States; D014486:United States Food and Drug Administration
D057947:Parenteral Nutrition Solutions; D000535:Aluminum