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Elevated plasma aluminum levels in normal infants receiving antacids containing aluminum
V M Tsou1, R M Young, M H Hart
1Department of Pediatrics, Creighton University School of Medicine, Omaha.
Insights
Infants receiving aluminum antacids showed elevated plasma aluminum levels, even with normal kidney function. Careful monitoring of aluminum dosage and levels is crucial for infant safety.
Area of Science:
- Pediatric Nephrology
- Clinical Toxicology
- Infant Nutrition
Background:
- Aluminum toxicity can cause serious health issues like encephalopathy and anemia.
- Renal insufficiency increases the risk of aluminum accumulation and toxicity.
- Previous studies demonstrated aluminum toxicity in uremic children using aluminum antacids.
Purpose of the Study:
- To investigate if plasma aluminum levels increase in infants with normal renal function during prolonged use of aluminum-containing antacids.
- To assess the safety of aluminum antacids in infants without kidney impairment.
Main Methods:
- A comparative study involving ten infants receiving aluminum antacids and sixteen control infants not receiving antacids.
- Study infants consumed a mean of 123 mg/kg/day of elemental aluminum for an average of 4.7 weeks.
- Plasma aluminum levels were measured and compared between the study and control groups.
Main Results:
- Study infants had significantly higher plasma aluminum levels (37.2 +/- 7.13 micrograms/L) compared to controls (4.13 +/- 0.66 micrograms/L).
- The difference in plasma aluminum levels was statistically significant (P < .005).
- Elevated levels were observed despite infants having normal renal function.
Conclusions:
- Plasma aluminum levels can increase in infants with normal renal function during high-dose, prolonged aluminum antacid use.
- The safety of aluminum-containing antacids in infants is not guaranteed.
- Judicious use and careful monitoring of aluminum dosage and plasma levels are recommended for infants.
Abstract:
Aluminum toxicity is a documented cause of encephalopathy, anemia, and osteomalacia. Excretion is primarily renal; therefore, patients with renal insufficiency are at risk for aluminum accumulation and toxicity. This has been demonstrated in uremic children treated with aluminum-containing antacids. The purpose of this study was to determine whether plasma aluminum levels were elevated in infants with normal renal function during prolonged aluminum-containing antacid use. Ten study infants (mean age = 5.8 months), who had been receiving antacids for at least 1 week, were compared with 16 control infants (mean age = 9.8 months) not receiving antacids. The study patients consumed 123 +/- 16 mg/kg per day (mean +/- SEM) of elemental aluminum for an average of 4.7 weeks. Their plasma aluminum level (37.2 +/- 7.13 micrograms/L) was significantly greater than that of the control group (4.13 +/- 0.66 micrograms/L) (P less than .005). It is concluded that plasma aluminum levels may become elevated in infants with normal renal function who are consuming high doses of aluminum-containing antacids. The safety of antacids containing aluminum should not be assumed and they should be used judiciously in infants, with careful monitoring of the aluminum dose and plasma level.