High deposition rate of aluminum in tissues in diabetic hemodialysis patients

• Published in: Nihon Jinzo Gakkai shi Vol. 32; no. 6; pp. 723 - 728
• Main Authors: IWASAKI, SHIGEKI, YOSHIMURA, ASHIO, IDEURA, TERUKUNI, SUDO, MUTSUO, CHIMATA, MINORU, KAWAMURA, MOTOHIRO, KOSHIKAWA, SHOZO
• Format: Journal Article
• Language: Japanese
• Published: Japan Japanese Society of Nephrology 1990
• Subjects: Adult; Aged; Aluminum - pharmacokinetics; Aluminum accumulation; Deferoxamine; deferroxamine; Diabetic Nephropathies - metabolism; Diabetic Nephropathies - therapy; diabetic patients; Female; Glomerulonephritis - metabolism; Glomerulonephritis - therapy; hemodialysis; Humans; Male; Middle Aged; Renal Dialysis; Tissue Distribution
• ISSN: 0385-2385; 1884-0728
• DOI: 10.14842/jpnjnephrol1959.32.723

Aluminum (A1) accumulation in bone is a serious problem in patients on hemodialysis. We studied def erroxamin-infusion test (DFO test) in 14 diabetic patients on hemodialysis (HDDM) and 23 hemodialysis patients originated from glomerulo nephritis (HDCGN) to determine whether Al accumulation is different between the two groups or not. There was no difference in hemodialysis duration and total oral intake of Al containing drugs between two groups. Serum C-terminal parathyroid hormone (C-PTH) in HDDM was lower than that in HDCGN group (1.82±1.30 vs. 3.80±1.82 ng/ml ; P<0.01). However serum Al (s-Al) levels were comparable (61.9±53.0 vs, 45.0±32.3 μg/l). A significant correlation was observed between duration of dialysis period and s-Al in HDDM (r= 0.806, p<0.01), but in HDCGN, the relation was not significant. The patients in HDDM whose cumulative aluminum intake was less than 2.0 kg showed the higher serum Al concentrations before DFO and greater increases in s-Al after DFO test, as compared with those in HDCGN with matched alminum intake (93.8±67.6 vs. 35.9±23.6 μg/l ; p<0.001 and 141.2±81.8 vs. 70.3±41.1μg/l ; p=0.035). These results indicate that in uremic diabetic patients with lower intake of Al containing drugs, an early accumulation of Al in the whole body occurs possibly because of the enhanced absorption rate of Al at an intestine and/or the low PTH level.