title: Excessive aluminum accumulation in the bones of patients on long-term parenteral nutrition: postmortem analysis by electrothermal atomic absorption spectrometry.
abstract: BACKGROUND
  Aluminum (Al) contamination of parenteral nutrition (PN) solutions remains a concern for long-term PN patients. Al accumulates particularly in bone. Excessive exposure to Al may result in increased Al body burden and impaired bone formation and mineralization, leading to bone disease. Although the U.S. Food and Drug Administration (FDA) has limited Al contamination in large-volume parenteral solutions, small-volume parenterals may still contribute considerable amounts of Al to PN solutions. The goal of this study is to determine whether or not long-term adult PN patients remain at risk for increased bone Al accumulation.
  
  
  METHODS
  We measured Al accumulation in autopsy bones from 7 patients who had received PN for 2-21 years and compared bone Al levels with those in living control patients undergoing hip or knee replacement. Electrothermal atomic absorption spectrometry was used for bone Al measurements.
  
  
  RESULTS
  When compared with bone Al content in controls, markedly elevated Al levels (P < .0001) were found in the bones of all but 1 patient, who received PN for only 2 years before death. Even greater Al accumulation was found for PN patients who developed late renal impairment (P = .0159).
  
  
  CONCLUSIONS
  We conclude that long-term adult PN patients continue to be at risk for Al toxicity.
authors.affiliation: Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, Albany, New York.
authors.forename: Pamela C
authors.initials: PC
authors.lastname: Kruger
authors.affiliation: Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, Albany, New York Department of Environmental Health Sciences, School of Public Health, The University at Albany, State University of New York, Albany, New York pparsons@wadsworth.org.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Parsons
authors.affiliation: Department of Environmental Health Sciences, School of Public Health, The University at Albany, State University of New York, Albany, New York.
authors.forename: Aubrey L
authors.initials: AL
authors.lastname: Galusha
authors.affiliation: Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, Albany, New York.
authors.forename: Michelle
authors.initials: M
authors.lastname: Morrissette
authors.affiliation: Osteoporosis Research Center, Creighton University School of Medicine, Omaha, Nebraska.
authors.forename: Robert R
authors.initials: RR
authors.lastname: Recker
authors.affiliation: Department of Medicine, Division of Gastroenterology and Nutrition, Albany Medical College, Albany, New York.
authors.forename: Lyn J
authors.initials: LJ
authors.lastname: Howard
mesh_terms: D000328:Adult; D000368:Aged; D000535:Aluminum / Q000737:chemistry*; D001344:Autopsy / Q000379:methods*; D001842:Bone and Bones / Q000737:chemistry*; D004340:Drug Contamination; D006801:Humans; D008875:Middle Aged; D010288:Parenteral Nutrition / Q000009:adverse effects*; D057947:Parenteral Nutrition Solutions / Q000737:chemistry; D015203:Reproducibility of Results; D013054:Spectrophotometry, Atomic; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D057947:Parenteral Nutrition Solutions; D000535:Aluminum
keywords: aluminum; bone; electrothermal atomic absorption spectrometry; parenteral nutrition