Publication
Title
Effect of aluminum on markers of bone formation resorption in chronic hemodialysis patients
Author
Abstract
Background: The prevalence of aluminum (Al)-related toxicity in hemodialysis (HD) patients has declined. However, some HD patients continue to receive Al-based phosphate binders, in part because of the expense of Al-free binders. Objective: To explore the effect of Al-based binders and their discontinuation on iron status, and markers of bone formation resorption in HD patients. Methods: Following an initial screen of serum Al levels in 37 HD patients, a second screening was performed after discontinuation of Al-based binders in a 2-year follow-up. A desferrioxamine (DFO; 5 mg/kg) test, andassessment of iron status and bone markers were conducted in the second screening. Results: Mean serum Al level was initially 27.8 ± 10.3 ?g/L. Thirteen patients had a serum Al >30 ?g/L, a level considered possibly toxic. There was a positive correlation between serum Al levels, HD duration,and cumulative dose of Al-based binder. At the second screening, the mean serum Al level decreased to 12.5 ± 7.4 ?g/L. The mean serum Al level increased to 26.0 ± 14.7 ?g/L post-DFO, but in none of the patients did the change in serum Al exceed the 50 ?g/L threshold associated with Al-induced bone disease. The decrease in serum Al level was associated with a significant increase in intact parathyroid hormone (iPTH) whereas total alkaline phosphatase did not change. Conclusions: We recommend that if Al-based phosphate binders are used in HD patients, serum Al level, iron, and markers of bone formation resorption be closely monitored to ensure safe use of these drugs.
Language
English
Source (journal)
Asian biomedicine: research, reviews and news. - Bangkok
Publication
Bangkok : 2014
ISSN
1905-7415
Volume/pages
8:4(2014), p. 485-492
ISI
000345883100006
Full text (Publisher's DOI)
Full text (publisher's version - intranet only)
UAntwerpen
Faculty/Department
Research group
[E?say:metaLocaldata.cgzprojectinf]
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identification
Creation 08.01.2015
Last edited 17.11.2017
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