Aluminium osteomalacia in chronic renal failure patients neither on dialysis nor taking aluminium containing phosphate binders
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The incidence of aluminium osteomalacia (ALO) in patients with chronic renal failure neither on dialysis nor taking aluminium-containing phosphate binders (ACPB) is not well documented. Biochemical and histological bone investigations were performed in 35 patients fulfilling the above conditions, among whom we found an incidence of ALO of 17%. In the ALO group, salient findings were PTH level (mean ± s.d.) of 3.1±1.4 ng/ml (normal <0.5 ng/ml); elevated home tap-water aluminium levels of 6.5±1.2 umol/1 (normal <2 umol/1); and a GFR of 20.5 mls/min/ 1.73m, (range 2–50 mls/min/1.73m).
We conclude that the aetiology of ALO in this group involves the absorption of toxic home water aluminium in the presence of an elevated PTH level and a GFR <50 mls/min/1.73m.
KeywordsOsteomalacia Phosphate Binder Renal Osteodystrophy Chronic Renal Failure Patient Chronic Pyelonephritis
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