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Prospective evaluation of aluminum loading from formula in infants with uremia
I B Salusky1, J W Coburn, P Nelson
1Department of Pediatrics, University of California, School of Medicine, Los Angeles.
Insights
Similac PM 60/40 infant formula is safe for infants with chronic renal failure undergoing dialysis. Studies show no significant aluminum accumulation, ensuring infant safety during treatment.
Area of Science:
- Nephrology
- Pediatrics
- Toxicology
Background:
- Infants with chronic renal failure (CRF) require specialized nutrition.
- Aluminum exposure is a concern in patients with impaired kidney function.
- Assessing aluminum loading from infant formula is crucial for this vulnerable population.
Purpose of the Study:
- To evaluate potential aluminum accumulation in infants with CRF using Similac PM 60/40.
- To determine the safety of this formula as a sole milk substitute in pediatric dialysis patients.
Main Methods:
- Serial plasma aluminum level measurements.
- Assessment of aluminum mobilization post-deferoxamine infusion.
- Bone histomorphometry and aluminum content analysis.
Main Results:
- Initial plasma aluminum levels were slightly elevated but remained below 0.92 mumol/L during follow-up.
- Deferoxamine infusion showed expected aluminum mobilization.
- Bone aluminum staining was negative, and bone aluminum content was only moderately increased.
Conclusions:
- Similac PM 60/40 can be safely administered to infants with chronic renal failure.
- The formula does not lead to significant aluminum toxicity in this patient group.
- This finding supports the use of Similac PM 60/40 in pediatric CRF management.
Abstract:
Assessment of potential aluminum loading from regular ingestion of a commercial infant formula (Similac PM 60/40), as the only milk substitute, was made in 14 infants aged 9.6 +/- 4.4 months who were also undergoing continuous cycling peritoneal dialysis. Tissue aluminum accumulation was assessed by serial measurements of plasma aluminum levels, from the increment in plasma aluminum after a standardized deferoxamine infusion, and from quantitative histomorphometry of bone and measurements of total bone aluminum content. Initial mean plasma aluminum levels were 0.61 +/- 0.32 mumol/L, (normal 0.30 +/- 0.04 mumol/L), and values were less than 0.92 mumol/L during the follow-up of 20 +/- 8 months. Plasma aluminum levels increased from 0.59 +/- 0.18 to 0.88 +/- 0.22 mumol/L after a single dose of deferoxamine. The histochemical stain for bone aluminum was negative for all patients, and the bone aluminum content was 0.27 +/- 0.22 mmol/kg dry weight (normal 0.08 +/- 0.04 mmol/kg dry weight). Thus the infant formula Similac PM 60/40 can be safely used in infants with chronic renal failure.