Aluminum in Subjects Receiving Parenteral Nutrition

  • Denise Bohrer
Living reference work entry


Al is ubiquitous, facilitating potential exposure to this element. Nevertheless, its poor absorption via the gastrointestinal tract protects the vast majority of the population from the risk of Al loading and toxicity. However, when the protective gastrointestinal mechanism is bypassed, as occurs in parenteral nutritional therapy, Al is prone to accumulate in the body. Due to this accumulation, Al is implicated in metabolic bone disease associated with parenteral nutrition in both pediatric and adult patients. Neonates are at an increased risk of aluminum toxicity because of anatomic, physiologic, and nutrition-related factors not present in other populations. Regulatory agencies recommended restricting parenteral aluminum administration to less than 5 μg/kg/day, and the US Food and Drug Administration requires that additives used to compound parenteral nutrition (PN) have the maximum aluminum content at the date of expiration listed on the product label and that large-volume parenterals contain no more than 25 μg/L aluminum. Despite legislative efforts, some factors make it difficult to comply with this rule, and therefore, with the current products used to compound formulations for nutritional therapy, the limits are rarely achieved.


Parenteral Nutrition Total Parenteral Nutrition Calcium Gluconate Mental Development Index Parenteral Nutrition Solution 
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List of Abbreviations


Ethylenediaminetetraacetic acid


Food and Agriculture Organization


Food and Drug Administration




Mental Development Index


Medicine and Healthcare Products Regulatory Agency


Neonatal intensive care unit


No-observed-adverse-effect level


Parenteral nutrition


Parathyroid hormone


Provisional tolerable weekly intake


Total parenteral nutrition


World Health Organization


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of ChemistryFederal University of Santa MariaSanta MariaBrazil

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