title: Increased Serum Al Levels in Hemodialysis Patients Kept Enhanced during a 2-Year Prospective Study.
abstract: The regulation of mineral homeostasis is altered in hemodialysis patients with renal insufficiency, producing increased risk for secondary diseases like cardiovascular ones. We hypothesized that risen serum aluminum (Al) concentration in hemodialysis patients kept enhanced during a 2-year longitudinal study is associated with enhanced cardiovascular risk and influenced by medical treatments. This study reports the prospective monitoring of serum Al levels in six-monthly samplings over 2 years in 116 hemodialysis patients and a control group of 50 healthy adults. The influence of other factors like sex, age, kidney transplant, disease etiology, and drug consumption was also considered. At each sampling, serum Al levels were significantly higher in the patients than in the healthy controls (P < 0.05). Levels in the patient group were statistically significantly lower at the third and fourth versus first and second samplings, which may be related to Al accumulation in tissues. Increased Al levels in patients were positively and significantly related to serum calcium (Ca) and uric acid levels. Serum Al concentrations were significantly lower in patients receiving vasodilators and diuretics. Higher serum Al levels in hemodialyzed patients administered with phosphate binders or anti-hyperkalemics are attributable to their usual Al salt content. The consumption of antianemic drugs increases Al absorption by forming more bioavailable complexes with the compounds in these drugs. In conclusion, this is the first study to indicate that cardiovascular problems associated with elevated serum Al levels in hemodialysis patients may be in part mitigated by administrating vasodilators and diuretics, which reduce these levels.
authors.affiliation: Department of Nutrition and Food Science, School of Pharmacy, University of Granada, 18071, Granada, Spain.
authors.forename: Maria L
authors.initials: ML
authors.lastname: Reina de la Torre
authors.affiliation: Department of Nutrition and Food Science, School of Pharmacy, University of Granada, 18071, Granada, Spain.
authors.forename: Herminia
authors.initials: H
authors.lastname: Lopez García de la Serrana
authors.affiliation: Department of Nutrition and Food Science, School of Pharmacy, University of Granada, 18071, Granada, Spain.
authors.forename: Loreto
authors.initials: L
authors.lastname: Martí Del Moral
authors.affiliation: Department of Hemodialysis, Guadix Hospital, Granada, Spain.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Palomares Bayo
authors.affiliation: Department of Nutrition and Food Science, School of Pharmacy, University of Granada, 18071, Granada, Spain. nalarcon@ugr.es.
authors.forename: Miguel
authors.initials: M
authors.lastname: Navarro-Alarcón
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000535:Aluminum / Q000097:blood*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000097:blood* / Q000628:therapy*; D012737:Sex Factors
chemical_list: D000535:Aluminum
keywords: Cardiovascular risk; Case-control study; Hemodialysis patients; Medications; Serum Al