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
- 4.Andreoli, S. P., Bergstein, J. M., Sherrard, D. J. Alumunium intoxication from aluminiumcontaining phosphate binders in children with azotaemia not undergoing dialysis. N. Eng. J. Med. 1984: 310, 1079–1084.Google Scholar
- 5.Goldner, J. A modification of the Masson trichome technique for routine laboratory purposes. Am. J. Path. 1938: 14, 237–242.Google Scholar
- 6.Lillie, P. D., Fullmer, H. M. Histopathologic technique and practical histochemistry. McGraw-Hill, New York, 1976.Google Scholar
- 7.Mora Pataia, F. J., Ellis, H. A., Cook, D. B., Dewar, J. H., Ward, M. K., Wilkinson, R., Kerr, D. N. S. Osteomalacia in patients with chronic renal failure before dialysis or transplantation. Q. J. Med. 1983: 207, 332–348.Google Scholar
- 8.Milliner, D. S., Nebeker, H. G., Ott, S., Andress, D. L., Sherrard, D. J., Alfrey, A. C., Slatopolsky, E. A., Coburn, J. W. Use of desferrioxamine infusion test in the diagnosis of aluminium-related osteodystrophy. N. Eng. J. Med. 1984: 101, 775–780.Google Scholar
- 9.Andress, D. L., Kopp, J. B., Maloney, M. A., Coburn, J. W., Sherrard, D., J. Early deposition of aluminium in bone in diabetic patients on haemodialysis. N. Eng. J. Med. 1987: 316, 292–296.Google Scholar
- 10.Marsden, S.N. E., Parkinson, I. S., Ward, M. K., Ellis, H. A., Kerr, D. N. S. Evidence for aluminium accumulation in renal failure. Proc, Eur. Dial. Transplant Ass. 1979: 16, 588–594.Google Scholar
- 13.Alfrey, A. C. Aluminium. Adv. Clin. Chem. 1983: 23, 69–91.Google Scholar
- 14.Ott, S. Aluminium accumulation in patients with normal renal function. Am. J. Kidney Dis. 1986: 6, 297–301.Google Scholar
- 15.Mayor, G. H., Burnatowska-Hledin, M. A. Impaired renal function and aluminium metabolism. Fed. Prod. 1983: 42, 279–283.Google Scholar