Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Recent Developments in Aluminium Toxicology


Aluminium is now recognised as an important toxin causing considerable morbidity and mortality, particularly in patients with chronic renal failure. Diseases that have been associated with aluminium include dialysis dementia, renal osteodystrophy and Alzheimer’s disease. Aluminium also has an effect on red blood cells, parathyroid glands and chromosomes.

Accumulation of aluminium in the body tends to occur when the gastrointestinal barrier is circumvented. This has been identified as a problem during dialysis or intravenous fluid administration. Renal functional impairment results in decreased aluminium excretion and promotes accumulation of the element in the body.

Many sources have been shown to be contaminated with aluminium. These include the water used for dialysis; medicines containing aluminium, such as aluminium-containing phosphate binding gels; total parenteral nutrition solutions; processed human serum albumin; intravenous fluids in infants; and other environmental and industrial sources.

The management of aluminium toxicity involves the identification of these contaminated sources and subsequent removal of the element. This includes regular monitoring of water used in dialysis. The use of aluminium-containing phosphate binding gels in patients with compromised renal function should be reviewed and alternatives sought. The development of effective aluminium-free phosphate binders is desirable. Once a patient has aluminium toxicity, desferrioxamine (deferoxamine) has been shown to be an effective agent in its chelation and removal.

This is a preview of subscription content, log in to check access.


  1. Ackrill P, Day JP, Garstang FM, Hodge KC, Metcalfe PJ, et al. Treatment of fracturing renal osteodystrophy by desferrioxamine. Proceedings of the European Dialysis and Transplant Association 19: 203–207, 1982

  2. Ackrill P, Ralston AJ, Day JP. Role of desferrioxamine in the treament of dialysis encephalopathy. Kidney International 29: S104–S107, 1986

  3. Ackrill P, Ralston AJ, Day JP, Hodge KC. Successful removal of aluminium from a patient with dialysis encephalopathy. Lancet 2: 692–693, 1980

  4. Adan L, Hainline BW, Zackson DA. The importance of accurate and precise aluminium levels. New England Journal of Medicine 313: 1609, 1985

  5. Alfrey AC. Aluminium and tin. In Bonner & Coburn (Eds) Disorders of mineral metabolism, Vol. I, pp. 353–368, Academic Press Inc, New York, 1981

  6. Alfrey AC. Aluminium intoxication. New England Journal of Medicine 310: 1113–1115, 1984

  7. Alfrey AC. Dialysis encephalopathy. Clinical Nephrology 24: S15–S19, 1985a

  8. Alfrey AC. The case against aluminium affecting parathyroid function. American Journal of Kidney Diseases 6: 309–312, 1985b

  9. Alfrey AC, LeGendre GR, Kaehny WD. The dialysis encephalopathy syndrome. New England Journal of Medicine 294: 184–188, 1976

  10. Altmann P, Al-Salihi F, Butler K, et al. Serum aluminium levels and erythrocyte dihydropteridine reductase activity in patients on haemodialysis. New England Journal of Medicine 317: 80–84, 1987

  11. Andreoli SP, Bergstein JM, Sherrard DJ. Aluminium intoxication from aluminium-containing phosphate binders in children with azotemia not undergoing dialysis. New England Journal of Medicine 310: 1079–1084, 1984

  12. Andreoli SP, Dunson JW, Bergstein JM. Calcium carbonate is an effective phophorus binder in children with chronic renal failure. American Journal of Kidney Diseases 9: 206–210, 1987

  13. Andress DL, Kopp JB, Maloney NA, Coburn JW, Sherrard DJ. Early deposition of aluminium in bone in diabetic patients on haemodialysis. New England Journal of Medicine 316: 292–296, 1987

  14. Andress DL, Ott SM, Maloney NA, Sherrard DJ. Effect of parathyroidectomy on bone aluminium accumulation in chronic renal failure. New England Journal of Medicine 312: 468–473, 1985

  15. Arieff AI. Aluminium and the pathogenesis of dialysis encephalopathy. American Journal of Kidney Diseases 6: 317–321, 1985

  16. Balasa RW, Murray RL, Kondelis NP, Bischel MD. Phosphate binding properties and electrolyte content of aluminium hydroxide antacids. Nephron 45: 16–21, 1987

  17. Banks WA, Kastin AJ. Aluminium increases permeability of the blood-brain barrier to labelled DSIP and beta-endorphin: possible implications for senile and dialysis dementia. Lancet 2: 1227–1229, 1983

  18. Barratt LJ, Lawrence JR. Dialysis-associated dementia. Australian and New Zealand Journal of Medicine 5: 62–65, 1975

  19. Berlyne GM, Adler AJ. Serum aluminium cannot be measured accurately. American Journal of Kidney Diseases 6: 288–292, 1985

  20. Berlyne GM, Ben Ari J, Knopf E, Yagil R, Weinberger G, et al. Aluminium toxicity in rats. Lancet 1: 564–568, 1972

  21. Bonal J, Montoliu J, Lopez Pedret J, et al. Desferrioxamine induced aluminium removal in haemodialysis. Proceedings of the European Dialysis and Transplant Association 21: 366–370, 1984

  22. Boyce N, Wood C, Holdsworth S, Thomson NM, Atkins RC. Life-threatening sepsis complicating heavy metal chelation therapy with desferrioxamine. Australian and New Zealand Journal of Medicine 15: 654–655, 1985

  23. Bugiani O, Brancaccio D, Ghetti B. Progressive dialytic encephalopathy and the problem of aluminium neurotoxicity. Clinical Nephrology 24: S20–S25, 1985

  24. Burnatowska-Hledin MA, Doyle TM, Eadie M, Mayor GH. 1,25-Dihydroxyvitamin D3 (1,25(OH)2D3) increases gastrointestinal (GI) absorption and serum and tissue concentration of aluminium in rats. Federation Proceedings 43: 338, 1984

  25. Burnatowska-Hledin M, Mayor GH. Aluminium: analytical considerations. American Journal of Kidney Diseases 6: 283–287, 1985

  26. Burnatowska-Hledin M, Mayor GH, Lau K. Renal handling of aluminium in the rat: clearance and micropuncture studies. American Journal of Physiology 249: F192–F197, 1985

  27. Cann CE, Prussin SG, Gordan GS. Aluminium uptake by the parathyroid glands. Journal of Endocrinology and Metabolism 49(4): 543–545, 1979

  28. Cannata JB, Junor BJR, Briggs JD, Fell GS, Beastall G. Effect of acute aluminium overload on calcium and parathyroid-hormone metabolism. Lancet 1: 501–503, 1983

  29. Cases A, Campistol J, Kelly J, et al. Desferoxime induced ocular and auditory neurotoxicity in patients with chronic renal failure. Presented at the 10th International Congress of Nephrology, London, July 1987

  30. Cassidy MJD, Swanepoel CR, Bridges S, Marks IN. Does gastric acid secretion affect phosphate binding by aluminium phosphate binding gels in chronic renal failure? Nephrology, Dialysis and Transplantation 3: 358, 1988

  31. Chang TMS, Barre P. Effect of desferrioxamine on removal of aluminium and iron by coated charcoal haemoperfusion and haemodialysis. Lancet 2: 1051–1053, 1983

  32. Coriat A-M, Gillard RD. Beware the cups that cheer. Nature 321: 570, 1986

  33. Cornelis R, Schutyser P. Analytical problems related to Al-determination in body fluids, water and dialysate. Contributions to Nephrology 38: 1–11, 1984

  34. Cournot-Witmer G, Plachot JJ, Bourdeau A, et al. Effect of aluminium on bone and cell localisation. Kidney International 29: S37–S40, 1986

  35. Crapper DR, Krishnan SS, Dalton AJ. Brain aluminum distribution in Alzheimer’s disease and experimental neurofibrillary degeneration. Science 180: 511–513, 1973

  36. Crapper DR, Krishnan SS, Quittkat S. Aluminium, neurofibrillary degeneration and Alzheimer’s disease. Brain 99: 67–80,1976

  37. Cronan CS, Reiners WA, Reynolds RC, Lang GE. Forest floor leaching: contributions from mineral, organic, and carbonic acids in New Hampshire subalpine forests. Science 200: 309–311, 1978

  38. Cronan CS, Schofield CL. Aluminium leaching response to acid precipitation: effects on high-elevation watersheds in the Northeast. Science 204: 304–306, 1979

  39. Cronan CS, Walker WJ, Bloom PR. Predicting aqueous aluminium concentrations in natural waters. Nature 324: 140–143, 1986

  40. Davies SC, Hungerford JL, Arden GB, et al. Ocular toxicity with high-dose intravenous desferrioxamine. Lancet 2: 181–184, 1983

  41. De Boni U, Scott JW, Crapper DR. Intracellular aluminium binding: a histochemical study. Histochemistry 40: 31–37, 1974

  42. De Broe ME, D’Haese PCD, Elseviers MM, Clement J, Visser WJ, et al. Aluminium and end stage renal failure. Nephrology 2: 1086–1116, 1988

  43. Delaney JF. Spinal fluid aluminium levels in patients with Alzheimer disease. Annals of Neurology 5: 580–581, 1979

  44. D’Haese PC, van der Vyver FL, de Wolff FA, De Broe ME. Measurement of aluminium in serum, blood, urine and tissues of chronic haemodialysed patients by use of electrothermal atomic absorption spectroscopy. Clinical Chemistry 31: 24–29, 1985

  45. Dunstan CR, Evans RA, Hills E, Wong SYP, Alfrey AC. Effect of aluminium and parathyroid hormone on osteoblasts and bone mineralisation in chronic renal failure. Calcified Tissue International 36: 133–138, 1984

  46. Eiser AR, Slifkin RF, Neff MS. Intestinal mucormycosis in hemodialysis patients following deferoxamine. American Journal of Kidney Diseases 10: 71–73, 1987

  47. Elliott HL, MacDougall AI. Aluminium studies in dialysis encephalopathy. Proceedings of the European Dialysis and Transplant Association 15: 157–163, 1978

  48. Elliot HL, MacDougall AI, Haase G, et al. Plasmapheresis in the treatment of dialysis encephalopathy. Lancet 2: 940–941, 1978

  49. Ellis HA, Peart KM. Azotaemic renal osteodystrophy: a quantitative study on iliac bone. Journal of Clinical Pathology 26: 83–101, 1973

  50. Fell GS, Shenkin A, Halls DJ. Aluminium contamination of intravenous Pharmaceuticals, nutrients, and blood products. Lancet 1: 380, 1986

  51. Felsenfeld AJ, Harrelson TA, Gutman RA, et al. Osteomalacia after parathyroidectomy in patients with uremia. Annals of Internal Medicine 96: 34–39, 1982

  52. Folb PI. Intravenous infusions: solutions and emulsions. In Dukes MNG (Ed.) Side-effects of drugs annual 9, pp. 296–301, Elsevier Scientific Publishers, Amsterdam, 1985

  53. Foncin J-F. Alzheimer’s disease and aluminium. Nature 326: 136, 1987

  54. Frech W, Cedergren A, Cederberg C, Vessman J. Evaluation of some critical factors affecting determination of aluminium in blood, plasma, or serum by electrothermal atomic absorption spectroscopy. Clinical Chemistry 11: 2259–2263, 1982

  55. Freundlich M, Abitbol C, Zilleruelo G, et al. Infant formula as a cause of aluminium toxicity in neonatal uraemia. Lancet 2: 527–529, 1985

  56. Fuchs C, Armstrong VW, Quellhorst E, Scheler F. Prophylaxis and methods for early recognition of aluminium intoxication. Contributions to Nephrology 38: 81–91, 1984

  57. Halliwell B, Gutteridge JMC. Free radicals in biology and medicine, Clarendon Press, Oxford, 1985

  58. Henry DA, Goodman WG, Nudelman RK, et al. Parenteral aluminium administration in the dog, I: plasma kinetics, tissue levels, calcium metabolism, and parathyroid hormone. Kidney International 25: 362–369, 1984

  59. Hewitt CD, Ackrill P, Day JP. Copper removal from renal patients using desferrioxamine chelation to reduce aluminium overload. In Taylor A (Ed.) Aluminium and other trace elements in renal disease, pp. 223–227, Bailliere Tindall, London, 1986

  60. Hodge KC, Day JP, O’Hara M, Ackrill P, Ralston AJ. Critical concentrations of aluminium in water used for dialysis. Lancet 2: 802–803, 1981

  61. Holzberg M, Artis WM. Hydroxamate siderophore production by opportunistic and systemic fungal pathogens. Infection and Immunity 40: 1134–1139, 1983

  62. Hudson GA, Milne FJ, Oliver NJ, Reis P, Murray J, et al. Bone disease in patients on maintenance haemodialysis using softened or deionised water. South African Medical Journal 56: 439–443, 1979

  63. Ihle BU, Becker GJ. Gastrointestinal absorption of aluminium. American Journal of Kidney Diseases 6: 302–305, 1985

  64. Ihle BU, Buchanan MRC, Stevens B, Becker GJ, Kincaid-Smith P. The efficacy of various treatment modalities on aluminium associated bone disease. Proceedings of the European Dialysis and Transplant Association 19: 195–201, 1982

  65. Jennings AE, Bodvarsson M, Galicka-Piskorska G, Diefendorf AS, Simon GM, et al. Use of magnesium hydroxide and low magnesium dialysate does not permit reduction of aluminium hydroxide during continuous ambulatory peritoneal dialysis. American Journal of Kidney Diseases 8: 192–195, 1986

  66. Johnson NM. Acid rain: neutralization within the Hubbard Brook ecosystem and regional implications. Science 204: 497–499, 1979

  67. Kaehny WD, Alfrey AC, Holman RE, Shorr WJ. Aluminium transfer during hemodialysis. Kidney International 12: 361–365, 1977a

  68. Kaehny WD, Hegg AP, Alfrey AC. Gastrointestinal absorption of aluminium from aluminium-containing antacids. New England Journal of Medicine 296: 1389–1390, 1977b

  69. Karlik SJ, Eichorn GL, Crapper-McLachlan DR. Molecular interactions of aluminium with DNA. Neurotoxicology 1: 83–88, 1986

  70. Kaye M, Gagnon R. Aluminium and phosphate: the double bind. American Journal of Kidney Diseases 6: 365–367, 1985

  71. Kerr DNS, Ward MK, Arze RS, et al. Aluminium-induced dialysis osteodystrophy: the demise of ‘Newcastle Bone Disease’? Kidney International 29: S58–S64, 1986

  72. Klein GL, Alfrey AC, Miller NL, et al. Aluminium loading during total parenteral nutrition. American Journal of Clinical Nutrition 35: 1425–1429, 1982

  73. Koch KR, Pougnet MAB, De Villiers S, Monteagudo FSE. Increased urinary excretion of Al after drinking tea. Nature 333: 122, 1988

  74. Kovalchik MT, Kaehny WD, Hegg AP, Jackson JT, Alfrey AC. Aluminium kinetics during hemodialysis. Journal of Laboratory and Clinical Medicine 92: 712–720, 1978

  75. Krueger GL, Morris TK, Suskind RR, Widner EM. The health effects of aluminium compounds in mammals. Critical Reviews in Toxicology 13: 1–24, 1984

  76. Lai JCK, Guest JF, Leung TKC, Lim L, Davison AM. The effects of cadmium, manganese and aluminium on sodium-potassium-activated and magnesium-activated adenosine triphosphatase activity and choline uptake in rat brain synaptosomes. Biochemical Pharmacology 29: 141–146, 1980

  77. Leung FY, Hodsman AB, Muirhead N, Henderson AR. Ultrafiltration studies in vitro of serum aluminium in dialysis patients after deferoxamine chelation therapy. Clinical Chemistry 31: 20–23, 1985

  78. Levick SE. Dementia from aluminium pots? New England Journal of Medicine 303: 164, 1980

  79. Lione A. More on aluminium in infants. New England Journal of Medicine 314: 923, 1986

  80. Loeliger EA, de Wolff FA. Aluminium contamination of albumin-replacement solutions. New England Journal of Medicine 312: 1389–1390, 1985

  81. Longstreth WT, Rosenstock L, Heyer NJ. Potroom palsy? Neurologic disorder in three aluminium smelter workers. Archives of Internal Medicine 145: 1972–1975, 1985

  82. Maher ER, Brown EA, Curtis JR, Phillips ME, Sampson B. Accumulation of aluminium in chronic renal failure due to administration of albumin replacement solutions. British Medical Journal 292: 306, 1986

  83. Malberti F, Surian M, Colussi G, Poggio F, Minoia C, et al. Desferrioxamine induced aluminium removal in haemodialysis: comparison of different membranes. In Taylor A (Ed.) Aluminium and other trace elements in renal disease, pp. 203–208, Bailliere Tindall, London, 1986

  84. Malluche HH, Faugere MC. The cellular basis of aluminium bone disease and its relationship to vitamin D metabolism. Nephrology 2: 1082–1085, 1988

  85. Malluche HH, Ritz E, Lange HP, et al. Bone histology in incipient and advanced renal failure. Kidney International 9: 355–362, 1976

  86. Malluche HH, Smith AJ, Abreo K, Faugere MC. The use of deferoxamine in the management of aluminium accumulation in bone in patients with renal failure. New England Journal of Medicine 311: 140–144, 1984

  87. Manzler AD, Schreiner AW. Copper-induced acute hemolytic anemia: a new complication of hemodialysis. Annals of Internal Medicine 73: 409–412, 1970

  88. Massry SG. Prevention and treatment of the abnormalities of divalent ion metabolism in renal failure. Seminars in Nephrology 6: 114–121, 1986

  89. Mayor GH. The case for parathyroid hormone. American Journal of Kidney Diseases 6: 306–308, 1985

  90. Mayor GH, Keiser JA, Makdani D, Ku PK. Aluminium absorption and distribution: effect of parathyroid hormone. Science 197: 1187–1189, 1977

  91. Mayor GH, Sprague SM, Hourani MR, Sanchez TV. Parathyroid hormone-mediated aluminium deposition and egress in the rat. Kidney International 17: 40–44, 1980

  92. McDermott JR, Smith AI, Ward MK, Parkinson IS, Kerr DNS. Brain-aluminium concentration in dialysis encephalopathy. Lancet 1: 901–903, 1978

  93. McGonigle RJS, Parsons V. Aluminium induced anaemia in haemodialysis patients. Nephron 39: 1–9, 1985

  94. Milliner DS, Nebeker HG, Ott SA, Sherrard DJ, Andress DL, et al. Desferrioxamine infusion test for diagnosis of aluminium osteomalacia. Kidney International 25: 149, 1984

  95. Milliner DS, Shinaberger JH, Shuman P, Coburn JW. Inadvertent aluminium administration during plasma exchange due to aluminium contamination of albumin-replacement solutions. New England Journal of Medicine 312: 165–167, 1985

  96. Milne FJ, Hudson GA, Meyers AM, et al. Healing of fracturingbone disease occurring in patients on dialysis. South African Journal of Medicine 61: 955–959, 1982

  97. Milne FJ, Sharf B, Bell P, Meyers AM. The effect of low aluminium water and desferrioxamine on the outcome of dialysis encephalopathy. Clinical Nephrology 20: 202–207, 1983

  98. Monteagudo FSE, Isaacson LC, Wilson G, Hickman R, Folb PI. Aluminium excretion by the distal tubule of the pig kidney. Nephron 49: 245–250, 1988

  99. Monteagudo FSE, Wood L, Jacobs P, Folb PI, Cassidy M. Aluminium loading during therapeutic plasma exchange. Journal of Clinical Apheresis 3: 161–163, 1987

  100. Mora Palma FJ, Ellis HA, Cook DB, et al. Osteomalacia in patients with chronic renal failure before dialysis or transplantation. Quarterly Journal of Medicine 207: 332–348, 1983

  101. Morrissey J. The influence of phorbol myristate acetate (PMA) on parathyroid hormone secretion. Clinical Research 32: 404A, 1984

  102. Morrissey J, Rothstein M, Mayor G, Slatopolsky E. Suppression of parathyroid hormone secretion by aluminium. Kidney International 23: 699–704, 1983

  103. Morrissey J, Slatopolsky E. Effect of aluminium on parathyroid hormone secretion. Kidney International 29: S41–S44, 1986

  104. Muirhead N, Hollomby DJ, Leung FY, et al. Removal of aluminium during hemodialysis: effect of different dialyzer membranes. American Journal of Kidney Disease 8: 51–55, 1986

  105. Nordal KP, Taslseth T, Dahl E, et al. Aluminium overload, a predisposing condition for epileptic seizures in renal transplant patients treated with cyclosporin? Lancet 2: 153–154, 1985

  106. Nordstrom DK, Ball JW. The geochemical behavior of aluminium in acidified surface waters. Science 232: 54–56, 1986

  107. O’Hare JA, Murnaghan DJ. Reversal of aluminium-induced hemodialysis anemia by a low-aluminium dialysate. New England Journal of Medicine 306: 654–656, 1982

  108. Ondreicka R, Ginter E, Kortus J. Chronic toxicity of aluminium in rats and mice and its effects on phosphorus metabolism. British Journal of Industrial Medicine 23: 305–312, 1966

  109. Ott SM. Aluminium accumulation in individuals with normal renal function. American Journal of Kidney Disease 6: 297–301, 1985

  110. Ott SM, Maloney NA, Coburn JW, Alfrey AC, Sherrard DJ. The prevalence of bone aluminium deposition in renal osteodystrophy and its relation to the response to calcitriol therapy. New England Journal of Medicine 307: 709–713, 1982

  111. Ott SM, Maloney NA, Klein GL, et al. Aluminium is associated with low bone formation in patients receiving chronic parenteral nutrition. Annals of Internal Medicine 98: 910–914, 1983

  112. Parkinson IS, Ward MK, Feest TG, Fawcett RWP, Kerr DNS. Fracturing dialysis osteodystrophy and dialysis encephalopathy: an epidemiological survey. Lancet 1: 406–409, 1979

  113. Parkinson IS, Ward MK, Kerr DNS. A method for the routine determination of aluminium in serum and water by flameless atomic absorption spectrometry. Clinica Chimica Acta 125: 125–133, 1982

  114. Pearce AGE. Histochemistry: theoretical and applied, 3rd ed., Vol. 2, pp. 1407–1408, Churchill Livingstone, Edinburgh, 1972

  115. Perl DP, Brody AR. Alzheimer’s disease: x-ray spectrometric evidence of aluminium accumulation in neurofibrillary tangle-bearing neurons. Science 208: 297–299, 1980

  116. Perl DP, Gajdusek DC, Garruto RM, Yanagihara RT, Gibbs CJ Jr. Intraneuronal aluminium accumulation in amyotrophic lateral sclerosis and Parkinsonism-dementia of Guam. Science 217: 1053–1055, 1982

  117. Pierides AM, Edwards WG, Cullum UX, McCall JT, Ellis HA. Haemodialysis encephalopathy with osteomalacic fractures and muscle weakness. Kidney International 18: 115–124, 1980

  118. Platts MM, Anastassiades E. Dialysis encephalopathy: precipitating factors and improvement in prognosis. Clinical Nephrology 15: 223–228, 1981

  119. Pogglitsch H, Petek W, Wawschinek O, Holzer W. Treatment of early stages of dialysis encephalopathy by aluminium depletion. Lancet 2: 1344–1345, 1981

  120. Posner AS, Blumenthal NC, Boskey AL. Model of aluminium-induced osteomalacia: inhibition of apatite formation and growth. Kidney International 29: S17–S19, 1986

  121. Puntis JWL, Hall K, Booth IW. Plasma aluminium and prolonged parenteral nutrition in infancy. Lancet 2: 1332–1333, 1986

  122. Rahman H, Channon SM, Skillen AW, Ward MK, Kerr DNS. Protein binding of aluminium in normal subjects and in patients with chronic renal failure. Proceedings of the European Dialysis and Transplant Association 21: 360–365, 1984

  123. Recker RR, Blotcky AJ, Leffler JA, Rack EP. Evidence for aluminium absorption from the gastrointestinal tract and bone deposition by aluminium carbonate ingestion with normal renal function. Journal of Laboratory and Clinical Medicine 90: 810–815, 1977

  124. Robins-Browne RM, Prpic JK. Desferrioxamine and systemic yersiniosis. Lancet 2: 1372, 1983

  125. Schneider H, Kulbe KD, Weber H, Streicher E. High-effective aluminium free phosphate binder: in vitro and in vivo studies. Proceedings of the European Dialysis and Transplant Association 20: 725–729, 1983

  126. Schwarzbeck A, Wagner L, Squarr H-U, Strauch M. Clotting in dialyzers due to low pH of dialysis fluid. Clinical Nephrology 7: 125–127, 1977

  127. Sedman AB, Klein GL, Merritt RJ, et al. Evidence of aluminium loading in infants receiving intravenous therapy. New England Journal of Medicine 312: 1337–1343, 1985

  128. Shore D, Millson M, Holtz JL, King SW, Bridge TP, et al. Serum aluminium in primary degenerative dementia. Biological Psychiatry 15: 971–977, 1980

  129. Siebert FB, Wells HG. The effect of aluminium on mammalian blood and tissues. Archives of Pathology 8: 230–261, 1929

  130. Siegel N, Haug A. Aluminium interaction with calmodulin: evidence for altered structure and function from optical and enzymatic studies. Biochimica Biophysica Acta 744: 36–45, 1983

  131. Simon P, Allain P, Ang KS, Cam G, Mauras Y. Higher performance of polyacrylonitrile dialyser than cuprophan hollow fiber dialyser to remove aluminium (Al) by hemodialysis alone and following chelation with desferrioxamine (DFX). Abstract. Symposium on Aluminium and Renal Failure, Antwerp, 1981

  132. Simon P, Ang KS, Meyrier A, Allain P, Mauras Y. Desferrioxamine, ocular toxicity, and trace metals. Lancet 2: 512–513, 1983

  133. Simon P, Cam G, Ang KS. Frequency of aluminium intoxication in a dialyzed population. In Man et al. (Eds) Blood purification in perspective: new insights and future trends, pp. 129–131, ISAO Press, Cleveland, 1987

  134. Six KM, Goyer RA. Experimental enhancement of lead toxicity by low dietary calcium. Journal of Laboratory and Clinical Medicine 76: 933–942, 1970

  135. Slatopolsky E, Briker NS. The role of phosphorus restriction in the prevention of secondary hyperparathyroidism in chronic renal disease. Kidney International 4: 141–145, 1973

  136. Slatopolsky E, Weerts C, Lopez-Hilker S, et al. Calcium carbonate as a phosphate binder in patients with chronic renal failure undergoing dialysis. New England Journal of Medicine 315: 157–161, 1986

  137. Smith EC, Mahurkar SD, Mamdani BH, Dunea G. Diagnosing dialysis dementia. Dialysis and Transplantation 7: 1264–1274, 1978

  138. Spofforth J. Case of aluminium poisoning. Lancet 1: 1301, 1921

  139. Swartz RD. Deferoxamine and aluminium removal. American Journal of Kidney Diseases 6: 358–364, 1985

  140. Swartz RD, Domdrouski J, Burnatowska-Hledin M, Mayor GH. Microcytic anaemia: a marker for the diagnosis of aluminium toxicity. Proceedings of the European Dialysis and Transplant Association 22: 101–105, 1985

  141. Theriault G, Cordier S, Tremblay C, Gingras S. Bladder cancer in the aluminium industry. Lancet 1: 947–950, 1984

  142. Touam M, Martinez F, Lacour B, Bourdon R, Zingraff J, et al. Aluminium-induced, reversible microcytic anemia in chronic renal failure: clinical and experimental studies. Clinical Nephrology 19: 295–298, 1983

  143. Turkstra J, Beukes PJL, Brits RJN, Hambleton-Jones BB. Multielement characterisation of human hair by neutron activation analysis. South African Journal of Science 74: 182–184, 1978

  144. Turner MW, Ardila M, Hutchinson T, Prichard S, Barre PE, et al. Sporadic aluminium osteomalacia: identification of patients at risk. American Journal of Kidney Diseases 11: 51–56, 1988

  145. Van der Voet GB, de Wolff FA. Distribution of aluminium between plasma and erythrocytes. Human Toxicology 4: 643–648, 1985

  146. Wagner K, Lenz T, Keller F, et al. Does desferrioxamine induce aluminium load in patients on chronic haemodialysis? Proceedings of the European Dialysis and Transplant Association 22: 388–391, 1985

  147. Ward MK, Ellis HA, Feest TG, et al. Osteomalacic dialysis osteodystrophy: evidence for a water-borne aetiological agent, probably aluminium. Lancet 1: 841–845, 1978

  148. Wascher RA, Cohn JB. The differential diagnosis of Alzheimer’s disease. Geriatric Medicine Today 4: 38–48, 1985

  149. Washko PW, Cousins RJ. Effect of parathyroid hormone on the uptake of orally administered cadmium. Hormone and Metabolic Research 11: 378, 1979

  150. Wheeler DC, Beaman M, Warwick G, Walls J. Magnesium hydroxide as a phosphate binder in CAPD patients with elevated serum aluminium levels. Nephrology Dialysis and Transplantation 1: 122, 1986

  151. Williams J W, Vera SR, Peters TG, et al. Biliary excretion of aluminium in aluminium osteodystrophy with liver disease. Annals of Internal Medicine 104: 782–785, 1966

  152. Windus DW, Stokes TJ, Julian BA, Fenves AZ. Fatal rhizopus infections in hemodialysis patients receiving deferoxamine. Annals of Internal Medicine 107: 678–680, 1987

  153. Wing AJ, Brunner FP, Brynger H, et al. Dialysis dementia in Europe: report from the Registration Committee of the European Dialysis and Transplant Association. Lancet 1: 190–192, 1980

  154. Wisniewski H, Terry RD, Hirano A. Neurofibrillary pathology. Journal of Neuropathology and Experimental Neurology 29: 163–176, 1970

  155. Wong PCL, Lai JCK, Lim L, Davison AM. Selective inhibition of L-glutamate and gamma-aminobutyrate transport in nerve ending particles by aluminium, manganese and cadonium chloride. Journal of Inorganic Biochemistry 14: 253–260, 1981

  156. Wurtman RJ. Alzheimer’s disease. Scientific American 252(1): 48–56, 1985

  157. Yates CM, Simpson J, Russell D, Gordon A. Cholinergic enzymes in neurofibrillary degeneration produced by aluminium. Brain Research 197: 269–274, 1980

  158. Zoller KA, Andress DI, Caliscibetta CC, et al. Fatal disseminated phycomycosis (mucormycosis) during desferoxamine therapy of aluminium toxicity: report of 3 cases. Presented at 10th International Congress of Nephrology, London, July 1987

Download references

Author information

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Monteagudo, F.S.E., Cassidy, M.J.D. & Folb, P.I. Recent Developments in Aluminium Toxicology. Med Toxicol Adverse Drug Exp 4, 1–16 (1989).

Download citation


  • Chronic Renal Failure
  • Phosphate Binder
  • Desferrioxamine
  • Aluminium Toxicity
  • Renal Osteodystrophy