Elevated bone aluminum content in dialysis patients without osteomalacia.

Abstract:

:In almost all dialysis patients, bone aluminum content (BAC) is elevated in comparison with levels in normal subjects. Extremely high BAC (200 micrograms or more of aluminum per gram of bone) is significantly associated with classic aluminum-related osteomalacia. We noted three patients with elevated BAC but without histologic evidence of typical osteomalacia. Two of the patients had moderately severe osteitis fibrosa (hyperparathyroidism), and one patient had mixed uremic bone disease--predominantly hyperparathyroidism but some impairment of bone mineralization as well. As has recently been reported by others, the deferoxamine infusion test yielded unusual results in these patients. On the basis of our observations, we believe that an isolated measurement of BAC to determine whether aluminum-related osteomalacia is present has certain limitations. Aluminum-related bone disease can be accurately diagnosed only with use of bone histomorphometry. Elevated levels of immunoreactive parathyroid hormone may offer protection from the toxic effects of aluminum.

journal_name

Mayo Clin Proc

journal_title

Mayo Clinic proceedings

authors

McCarthy JT,Kurtz SB,McCall JT

doi

10.1016/s0025-6196(12)60539-4

subject

Has Abstract

pub_date

1985-05-01 00:00:00

pages

315-20

issue

5

eissn

0025-6196

issn

1942-5546

pii

S0025-6196(12)60539-4

journal_volume

60

pub_type

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