title: Risk factors and consequences of hyperaluminemia in a peritoneal dialysis cohort.
abstract: BACKGROUND
  Widespread Al toxicity is unusual today. In 2005, Canadian peritoneal dialysis (PD) centers reported widespread hyperaluminemia in patients using dialysates from one specific manufacturer. Our objectives were to evaluate risk factors related to Al accumulation and to assess its clinical consequences in patients from 2 centers.
  
  
  METHODS
  A retrospective closed cohort study was conducted in patients treated with PD in May 2005. A multivariate linear regression model was constructed to identify variables associated with a higher serum Al level in the exposed group at the moment of solution change. Using appropriate statistical methods, anemia and bone metabolism parameters were compared between the exposed and unexposed groups. Time to first peritonitis was estimated by the Kaplan-Meier method.
  
  
  RESULTS
  The study cohort included 87 Al-exposed patients and 95 unexposed patients. In the exposed group, serum Al at the moment of solution change was influenced by the length of exposure to Al-containing dialysates and by PD creatinine clearance; serum Al was inversely correlated with renal creatinine clearance. No consequences of Al accumulation were observed. No difference was observed in the time to first peritonitis between patients who switched manufacturers and those who remained with the original manufacturer.
  
  
  CONCLUSIONS
  Our results suggest that hyperaluminemia is directly related to the length and extent of exposure to Al-containing dialysates; residual renal function is protective against Al accumulation. Because the problem was detected rapidly, no clinical consequences of hyperaluminemia were observed in the study cohort.
authors.affiliation: Department of Medical Biology, Sacré-Coeur Hospital, Montreal, Quebec, Canada.
authors.forename: Valery
authors.initials: V
authors.lastname: Lavergne
authors.forename: Marc
authors.initials: M
authors.lastname: Ghannoum
authors.forename: Megan
authors.initials: M
authors.lastname: Christie
authors.forename: Van
authors.initials: V
authors.lastname: Vo
authors.forename: Paul W
authors.initials: PW
authors.lastname: Tam
authors.forename: Robert
authors.initials: R
authors.lastname: Ting
authors.forename: Tabo
authors.initials: T
authors.lastname: Sikaneta
mesh_terms: D000368:Aged; D000535:Aluminum / Q000097:blood* / Q000633:toxicity; D015331:Cohort Studies; D015314:Dialysis Solutions / Q000737:chemistry; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010538:Peritonitis / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D015314:Dialysis Solutions; D000535:Aluminum