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Original Paper

Bone Aluminium Deposition in Maintenance Dialysis Patients Treated with Aluminium-Free Dialysate: Role of Aluminium Hydroxide Consumption

Heaf J.G. · Pødenphant J. · Andersen J.R.

Author affiliations

Department of Nephrology, Hvidovre Hospital, University of Copenhagen; Departments of Pathology and Clinical Biochemistry, Glostrup County Hospital, University of Copenhagen; Department of Chemistry, Royal Danish School of Pharmacy, Copenhagen, Denmark

Related Articles for ""

Nephron 1986;42:210–216

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Accepted: May 28, 1985
Published online: December 04, 2008
Issue release date: 1986

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 0

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

For additional information: https://www.karger.com/NEF

Abstract

Postmortem iliac crest biopsies were performed on 16 uremic patients. 3 had been treated conservatively while 13 had been entered into a maintenance dialysis program. The dialysate was treated by reverse osmosis for more than 10 years, and the aluminium concentration was consistently below the detection limit of 0.15 mol/l.14 patients had been treated with aluminium hydroxide. Bone histomorphometry, aluminium labelling intensity, osteoid surface aluminium labelling extent (Al/OBI) and bone aluminium concentration were measured. 14 patients had significant bone aluminium deposition, including 2 who were not on dialysis of whom 1 had not received aluminium hydroxide. Bone aluminium concentration and labelling intensity were correlated to total aluminium hydroxide consumption (p < 0.001, p < 0.05) and present dose (p < 0.01, p < 0.01), while Al/OBI was not. The two patients with the highest aluminium concentrations had symptomatic osteomalacia, but 4 patients with significantly raised concentrations and mineralisation front labelling had secondary hyperparathyroidism. It is concluded that (1) bone aluminium deposition occurs despite the use of aluminium-free dialysate and is associated with total and present aluminium hydroxide consumption; (2) heavy aluminium deposition is associated with severe and symptomatic osteomalacia, but can also be observed in the presence of predominant hyperparathyroidism; (3) aluminium deposition can occur in the absence of treatment with dialysis or aluminium hydroxide; (4) bone aluminium concentration and labelling intensity are a better measure of bone deposition than Al/OBI.

© 1986 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Accepted: May 28, 1985
Published online: December 04, 2008
Issue release date: 1986

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 0

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

For additional information: https://www.karger.com/NEF


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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