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Deferoxamine and aluminum clearance in pediatric hemodialysis patients

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Abstract

Mobilization of aluminum by deferoxamine and the subsequent clearance from plasma by hemodialysis with or without charcoal hemofiltration was studied in four pediatric patients. Deferoxamine, 10–20 mg/kg, followed by dialysis with a Travenol CA50 dialyzer produced reductions in mean plasma aluminum levels from 2433±729 nmol/l (65.5±19.6 μg/l) to 1727±554 nmol/l (46.5±14.9 μg/l) during dialysis. The use of a charcoal cartridge in the circuit resulted in a reduction in mean plasma aluminum levels 2459±591 nmol/l (66.2±15.9 μg/ml) to 1380±106 nmol/l (35.8±2.9 μg/l). In one patient, high-flux dialysis produced a reduction from 2140 nmol/l (55.6 μg/l) to 1134 nmol/l (29.4 μg/l). No patients suffered direct adverse reactions to low-dose deferoxamine, although two patients had previously exhibited potential aluminum neurotoxicity after rapid increases in plasma aluminum levels with deferoxamine in higher doses. Aluminum levels must be monitored closely during deferoxamine therapy in uremic children to minimize the risk of exacerbating aluminum neurotoxicity.

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References

  1. 1.

    Salusky IB, Coburn JW, Foley J, Nelson P, Fine RN (1986) Effects of oral calcium carbonate on control of serum phosphorus and changes in plasma aluminum levels after discontinuation of aluminum-containing gels in children receiving dialysis. J Pediatr 108: 767–770

  2. 2.

    Eschbach JW, Egrie JC, Downing MR, Browne JK, Adamson JW (1987) Correction of the anemia of end-stage renal disease with recombinant human erythropoietin. N Engl J Med 316: 73–78

  3. 3.

    Gruskin AB (1988) Aluminum: a pediatric overview. Adv Pediatr 35: 281–330

  4. 4.

    Ackrill P, Day JP (1985) Desferrioxamine in the treatment of iron overload. Clin Nephrol 24: S94-S97

  5. 5.

    Ackrill P, Ralston AJ, Day JL, House KC (1980) Successful removal of aluminum from a patient with dialysis encephalopathy. Lancet II: 692–693

  6. 6.

    Malluche MM, Smith AJ, Abreo K, Faugere MG (1984) The use of deferoxamine in the management of aluminum accumulation in bone in patients with renal failure. N Engl J Med 311: 140–144

  7. 7.

    Chang TMS, Barre P (1983) Effect of desferrioxamine on removal of aluminum and iron by coated charcoal haemoperfusion and haemodialysis. Lancet II: 1051–1053

  8. 8.

    Andreoli SP, Dunn D, DeMeyer W, Sherrard DJ, Berestein JM (1985) Intraperitoneal deferoxamine therapy for aluminum intoxication in a child undergoing continuous ambulatory peritoneal dialysis. J Pediatr 107: 760–763

  9. 9.

    Freundlich M, Zilleruelo G, Faugere MC, Abitbol C, Strauss J, Malluche HH (1986) Treatment of aluminum toxicity in infantile uremia with deferoxamine. J Pediatr 109: 141–143

  10. 10.

    Warady BA, Ford DM, Gaston CE, Sedman AB, Huffer WE, Lum GM (1986) Aluminum intoxication in a child: Treatment with intraperitoneal deferoxamine. Pediatrcs 78: 651–655

  11. 11.

    Roodhoft AM, Van de Vyver FL, D'Haase PG, Van Acker KJ, Visser WJ, De Broe ME (1987) Aluminum accumulation in children on chronic dialysis: predictive value of serum aluminum levels and deferoxamine infusion test. Clin Nephrol 28: 125–129

  12. 12.

    Leung FY, Henderson AR (1982) Improved determination of aluminum in serum and urine with use of a stabilized temperature platform furnace. Clin Chem 28: 2139–2143

  13. 13.

    Crapper McLaughlan DR, Kruck TPA, Van Beritum MFA (1985) Aluminum and neurodegenerative disease: therapeutic implications. Am J Kidney Dis. 6: 322–329

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Correspondence to Malcolm R Ogborn.

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Ogborn, M.R., Dorcas, V.C. & Crocker, J.F.S. Deferoxamine and aluminum clearance in pediatric hemodialysis patients. Pediatr Nephrol 5, 62–64 (1991). https://doi.org/10.1007/BF00852849

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Key words

  • Aluminum
  • Hemodialysis
  • Hemofiltration
  • Iron
  • Deferoxamine