Aluminum and renal failure by Marc E. de Broe, Patrick C. D’Haese (auth.), Marc E. de

By Marc E. de Broe, Patrick C. D’Haese (auth.), Marc E. de Broe, Jack W. Coburn (eds.)

` ... the fabric awarded offers important info about the organic results and medical syndromes linked to aluminum publicity. This quantity might be invaluable for college kids and nephrologists who're drawn to furthering their knowing of the area.'
Dialysis and Transplantation, 20/1, January 1991

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This is a particularly high amount when compared with the average normal body content of Al for reference man, which is estimated at 295 mg [22]. The very high interindividual variation in Al retention is a remarkable fact too. In a 40-day balance study in which volunteers were administered Al as the lactate in fruit juice, Greger and Baier [23] also found asignificant increase in serum concentrations and urinary excretion, but no indication was found for any retention of AI. Brown et ai. [24], studying absorption from ace glut amide aluminum, also found that the Al absorbed from this complex was rapidly excreted in the urine and the feces.

For this reason the medication was discontinued and hyperphosphatemia was treated by partial parathyroidectomy. Both case histories show that oral Al hydroxide may lead to a serious increase in the internal dose of AI, in spite of regular hemodialysis. The role of oral Al hydroxide in the development of Al toxicity is also noted by a number of other authors [15-18]. These clinical observations do not offer a clue as to why most patients endure high doses for a long period of time with an acceptable rise in serum AI, whereas a minority apparently absorbes Al from its hydroxide to a large extent.

In these cases the increased absorption is possibly due to an increased activity of a saturable transport mechanism for which aluminum competes with calcium. After stimulation of endogenous calcitriol production by calcium-deficient diets, similar observations were made [10]. 34 Interferences of the parathyroid status with the distribution and toxicity of aluminum Effect of PTH on the uptake, distribution and elimination of aluminum. Studies in uremic rats have documented no effect of parathyroidectomy neither on gastrointestinal absorption [23], nor on urinary excretion of aluminum [4].

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