Aluminium toxicity in chronic renal insufficiency

Journal Article · Thu Aug 01 04:00:00 EDT 1985 · Clin. Endocrinol. Metab.; (United States)

DOI:https://doi.org/10.1016/S0300-595X(85)80012-8· OSTI ID:5631569

Savory, J; Bertholf, R L; Wills, M R

Aluminium is a ubiquitous element in the environment and has been demonstrated to be toxic, especially in individuals with impaired renal function. Not much is known about the biochemistry of aluminium and the mechanisms of its toxic effects. Most of the interest in aluminium has been in the clinical setting of the hemodialysis unit. Here aluminium toxicity occurs due to contamination of dialysis solutions, and treatment of the patients with aluminium-containing phosphate binding gels. Aluminium has been shown to be the major contributor to the dialysis encephalopathy syndrome and an osteomalacic component of dialysis osteodystrophy. Other clinical disturbances associated with aluminium toxicity are a microcytic anemia and metastatic extraskeletal calcification. Aluminium overload can be treated effectively by chelation therapy with desferrioxamine and hemodialysis. Aluminium is readily transferred from the dialysate to the patient's -bloodstream during hemodialysis. Once transferred, the aluminium is tightly bound to non-dialysable plasma constituents. Very low concentrations of dialysate aluminium in the range of 10-15 micrograms/l are recommended to guard against toxic effects. Very few studies have been directed towards the separation of the various plasma species which bind eluminium. Gel filtration chromatography has been used to identify five major fractions, one of which is of low molecular weight and the others appear to be protein-aluminium complexes. Recommendations on aluminium monitoring have been published and provide safe and toxic concentrations. Also, the frequency of monitoring has been addressed. Major problems exist with the analytical methods for measuring aluminium which result from inaccurate techniques and contamination difficulties. 136 references.

• OSTI ID: 5631569
• Journal Information: Clin. Endocrinol. Metab.; (United States), Journal Name: Clin. Endocrinol. Metab.; (United States) Vol. 3; ISSN CEDMB
• Country of Publication: United States
• Language: English

Related Subjects

560306* -- Chemicals Metabolism & Toxicology-- Man-- (-1987)
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ALUMINIUM
ANEMIAS
BIOCHEMISTRY
BIOLOGICAL MATERIALS
BLOOD
BODY
BODY FLUIDS
CALCINOSIS
CHELATING AGENTS
CHEMISTRY
CONTAMINATION
DISEASES
ELEMENTS
HEMIC DISEASES
KIDNEYS
MATERIALS
METALS
ORGANS
PATHOLOGICAL CHANGES
RECOMMENDATIONS
SYMPTOMS
TOXICITY
UROGENITAL SYSTEM DISEASES