Other clinical syndromes associated with aluminum

Microcytic anemia, joint pain, severe infections, liver dysfunction
  • Tilman B. Drüeke
Part of the Developments in Nephrology book series (DINE, volume 26)


The clinical hallmarks of aluminum intoxication in chronic hemodialysis patients are encephalopathy and osteopathy including osteomalacia and aplastic bone disease. Besides these, other complications have been observed such as microcytic anemia, joint pain and severe infections. In the following, we shall describe these more inconstant complications.


Uremic Patient Aluminum Toxicity Microcytic Anemia Hypochromic Anemia Osteitis Fibrosa 
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  1. 1.
    Eschbach JW, Adamson JW, 1985: Anemia of end-stage renal disease (ESRD). Kidney Int 28: 1.PubMedCrossRefGoogle Scholar
  2. 2.
    Winearls CG, Oliver DO, Pippard MJ, Reid C, Downing MR, Cotes PM, 1986: Effect on human erythropoietin derived from recombinant DNA on the anaemia of patients maintained by chronic haemodialysis. Lancet 2: 1175.PubMedCrossRefGoogle Scholar
  3. 3.
    Eschbach JW, Egrie JC, Downing MR, Browne JK, Adamson JW, 1987: Correction of the anemia of end-stage renal disease with recombinant human erythropoietin. Results of a combined phase I and II clinical. N Engl J Med 316: 73.PubMedCrossRefGoogle Scholar
  4. 4.
    McGonigle RJS, Parsons V, 1985: Aluminium-induced anaemia in haemodialysis patients. Nephron 39: 1.PubMedCrossRefGoogle Scholar
  5. 5.
    Elliott HL, MacDougall AI, 1978: Aluminium studies in dialysis encephalopathy. Proc Eur Dial Transplant Ass 15: 157.Google Scholar
  6. 6.
    Short AIK, Winney RJ, Robson JS, 1980: Reversible microcytic hypochromic anemia in dialysis patients due to aluminium intoxication. Proc Eur Dial Transplant Ass 17: 233.Google Scholar
  7. 7.
    O’Hare JA, Murnaghan DJ, 1982: Reversal of aluminium induced haemodialysis anaemia by a low-aluminium dialysate. N Engl J Med 306: 654.PubMedCrossRefGoogle Scholar
  8. 8.
    Tielemans C, Collart C, Wens R, Smeyers-Verbeeke J, van Hooff I, Dratwa M and Verbeelen D, 1985: Improvement of anemia with deferoxamine in hemodialysis patients with aluminum-induced bone disease. Clin Nephrol 24: 237.PubMedGoogle Scholar
  9. 9.
    Praga M, Andrés A, de la Serna J, Ruilope LM, Nieto J, Estenoz J, Millet VG, Arnaiz F, Rodicio JL, 1987: Improvement of anaemia with desferrioxamine in haemodialysis patients. Nephrol Dial Transplant 2: 243.PubMedGoogle Scholar
  10. 10.
    Swartz R, Dombrouski J, Burnatowsksa-Hledin M, Mayor G, 1987: Microcytic anemia in dialysis patients: reversible marker of aluminum toxicity. Am J Kidney Dis 9: 217.PubMedGoogle Scholar
  11. 11.
    Touam M, Martinez F, Lacour B, Bourdon R, Zingraff J, di Giulio S, T Driieke, 1983: Aluminium-induced, reversible microcytic anaemia in chronic renal failure: Clinical and experimental studies. Clin Nephrol 19: 295.PubMedGoogle Scholar
  12. 12.
    Kaiser L, Schwartz KL, Burnatowska-Hledin MA, Mayor G, 1984: Microcytic anemia secondary to intraperitoneal aluminum in normal und uremic rats. Kidney Int 26: 269.PubMedCrossRefGoogle Scholar
  13. 13.
    Meredith P, Moore P, Goldberg A, 1977: The effects of aluminum, lead and zinc on delta amino-levulinic acid dehydratase. Enzyme 22: 22.PubMedGoogle Scholar
  14. 14.
    Huber C, Frieden E, 1970: Substrate civilization and the kinetics of ferroxidase. J Biol Chem 245: 3973.PubMedGoogle Scholar
  15. 15.
    Huber C, Frieden E, 1970: The inhibition of ferroxidase by trivalent and other metal ions. J Biol Chem 245: 3979.PubMedGoogle Scholar
  16. 16.
    Trapp GA, 1983: Plasma aluminum is bound to transferrin. Life Sei 33: 3111.CrossRefGoogle Scholar
  17. 17.
    De Boni U, Scott JW, Crapper DR, 1974: Intracellular aluminum binding: a histochemical study. Histochemistry 40: 31.PubMedCrossRefGoogle Scholar
  18. 18.
    Kushelevski A, Yagil R, Alfasi Z, Berlyne GM, 1976: Uptake of aluminum ion by the liver. Biomedicine 25: 59.Google Scholar
  19. 19.
    Karlik SJ, Eichorn GL, Crapper McLachlan DR, 1980: Molecular interaction of aluminum with DNA. Neurotoxicity 1: 83.Google Scholar
  20. 20.
    Siegel N, 1985: Aluminum interaction with biomolecules: the molecular basis for aluminum toxicity. Am J Kidney Dis 6: 353.PubMedGoogle Scholar
  21. 21.
    Siegel N, Hang A, 1983: Aluminum interaction with calmodulin. Evidence for altered structure and function from optical and enzymatic studies. Biochim Biophys Acta 744: 36.PubMedCrossRefGoogle Scholar
  22. 22.
    Driieke T, Lacour B, Touam M, Jucquel JP, Plachot JJ, Cournot-Witmer G, Galle P, 1986: Effect of aluminum on hematopoiesis. Kidney Int 29 (suppl 18): S45.Google Scholar
  23. 22a.
    Mladenovic J, 1988: Aluminum inhibits erythropoiesis in vitro. J Clin Invest 81: 1661.Google Scholar
  24. 22b.
    Casati S, Passerini P, Campise MR, Graziani G, Cesana B, Perisic M, Ponticelli C, 1987: Benefits and risks of protacted treatment with human recombinant eryrhropoietin in patients having haemodialysis. Br Med J 295: 1017.CrossRefGoogle Scholar
  25. 23.
    Parkinson IS, Ward MK, Kerr DNS, 1981: Dialysis encephalopathy, bone disease and anaemia: the aluminium intoxication syndrome during regular haemodialysis. J Clin Pathol 34: 1285.PubMedCrossRefGoogle Scholar
  26. 24.
    Elliott HL, MacDougal AI, Fell GS, 1978: Aluminium toxicity syndrome. Lancet i: 1203.CrossRefGoogle Scholar
  27. 25.
    Roth A, Nogues C, Galle P, Driieke T, 1984: Multiorgan aluminium deposits in a chronic haemodialysis patient: electron microscope and microprobe studies. Virchows Arch 405: 131.CrossRefGoogle Scholar
  28. 26.
    London GM, de Vernejoul MC, Marchais SJ, Fabiani F, Guérin A, Metivier F, Llach F, 1987: Aluminum (Al) accumulation and cardiac hyperthrophy in hemodialysis patients: lesser risk in subjects with active hyperparathyroidism. Xth Internat Congr Nephrol, London, UK, July 1987, Abstract book, p. 436.Google Scholar
  29. 27.
    Wills MR, Savory J, 1983: Aluminium poisoning: dialysis encephalopathy, osteomalacia, and anaemia. Lancet 2: 29.PubMedCrossRefGoogle Scholar
  30. 28.
    Bachra BN, van Harskam GA, 1970: The effect of polyvalent metal ions on the stability of a buffer system for calcification in vitro. Calcif Tissue Res 4: 359.PubMedCrossRefGoogle Scholar
  31. 29.
    Sideman S, Manor D, 1982: The dialysis dementia syndrome and aluminum intoxication. Nephron 31: 1.PubMedCrossRefGoogle Scholar
  32. 30.
    Santos F, Massie MD, Chan JCM, 1986: Risk factors in aluminum toxicity in children with chronic renal failure. Nephron 42: 189.PubMedCrossRefGoogle Scholar
  33. 31.
    Alfrey AC, 1983: Aluminum. Adv Clin Chem 23: 69.PubMedCrossRefGoogle Scholar
  34. 32.
    Galle P, Giudicelli CP, 1982: Toxicité de Taluminum pour l’hépatocyte. Localisation ultrastructurale et microanalyse des dépôts. Nouv Presse 2: 1123.Google Scholar
  35. 33.
    Klein GL, Sedman AB, Heyman MB, Marathe G, Battifora HA, Worrall JL, Horst RL, Brewer GJ, Miller NL, Alfrey AC, 1987: Hepatic abnormalities associated with aluminum loading in piglets. J Parent Ent Nutr 11: 293.CrossRefGoogle Scholar
  36. 34.
    Verbueken AH, van de Vyver L, van Grieken RE, Paulus GJ, Visser WJ, D’Haese P, de Broe ME, 1984: Ultrastructural localization of aluminum in patients with dialysis-associated osteomalacia. Clin Chem 30: 763.PubMedGoogle Scholar
  37. 35.
    Drüeke T, Lacour B, Touam M, Basile C, Bourdon R, 1985. Oral aluminum intoxication in rats: role of uremia, parathyroid hormone, and vitamin D metabolites. Nephron 39: 10.PubMedCrossRefGoogle Scholar
  38. 36.
    Klein LG, Berquist WE, Ament ME, Coburn JW, Miller NL, Alfrey AC, 1984. Hepatic aluminum accumulation in children on total parenteral nutrition. J Pediatr Gastroenterol Nutr 3: 740.PubMedCrossRefGoogle Scholar
  39. 37.
    Klein L, Heyman MB, Lee TC, Alfrey AC, 1987: Cholestatic effects of aluminum in rats. Pediatr Res 21: 271-A.Google Scholar
  40. 38.
    Bidlack WR, Brown RC, Meskin MS, Lee TC, Klein GL, 1987: Effect of aluminum on the hepatic mixed function oxidase and drug metabolism. Drug-Nutrient Interactions 5: 33.PubMedGoogle Scholar
  41. 39.
    Simon P, Meyrier A, Brissot P, 1981: Uremia and the liver. II. Drugs and the liver in the uremic patient. Nephron 29: 7.PubMedCrossRefGoogle Scholar

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© Kluwer Academic Publishers 1990

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  • Tilman B. Drüeke

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