Surgery Today

, Volume 44, Issue 12, pp 2314–2317 | Cite as

Serum aluminum levels in dialysis patients after sclerotherapy of internal hemorrhoids with aluminum potassium sulfate and tannic acid

  • Akira TsunodaEmail author
  • Masafumi Nakagi
  • Nobuyasu Kano
  • Masahiko Mizutani
  • Kenji Yamaguchi
Original Article



Aluminum potassium sulfate and tannic acid (ALTA) is an effective sclerosing agent for internal hemorrhoids. However, it is contraindicated for patients with chronic renal failure on dialysis, because the aluminum in ALTA can cause aluminum encephalopathy when it is not excreted effectively. We conducted this study to measure the serum aluminum concentrations and observe for symptoms relating to aluminum encephalopathy in dialysis patients after ALTA therapy.


Ten dialysis patients underwent ALTA therapy for hemorrhoids. We measured their serum aluminum concentrations and observed them for possible symptoms of aluminum encephalopathy.


The total injection volume of ALTA solution was 31 mL (24–37). The median serum aluminum concentration before ALTA therapy was 9 μg/L, which increased to 741, 377, and 103 μg/L, respectively, 1 h, 1 day, and 1 week after ALTA therapy. These levels decreased rapidly, to 33 μg/L by 1 month and 11 μg/L by 3 months after ALTA therapy. No patient suffered symptoms related to aluminum encephalopathy.


Although the aluminum concentrations increased temporarily after ALTA therapy, dialysis patients with levels below 150 μg/L by 1 week and thereafter are considered to be at low risk of the development of aluminum encephalopathy.


Internal hemorrhoids Aluminum potassium sulfate and tannic acid (ALTA) Sclerotherapy Hemodialysis 


Conflict of interest

Akira Tsunoda and his co-authors have no conflicts of interest to declare.


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Copyright information

© Springer Japan 2014

Authors and Affiliations

  • Akira Tsunoda
    • 1
    • 2
    Email author
  • Masafumi Nakagi
    • 2
  • Nobuyasu Kano
    • 1
  • Masahiko Mizutani
    • 2
  • Kenji Yamaguchi
    • 3
  1. 1.Department of SurgeryKameda Medical CenterKamogawaJapan
  2. 2.Department of SurgeryAwa Regional Medical CenterTateyamaJapan
  3. 3.Department of NephrologyAwa Regional Medical CenterTateyamaJapan

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