Predictive value of serum aluminium levels for bone accumulation in haemodialyzed patients

Uremic patients undergoing long-term dialysis risk accumulating tissue aluminium burdens and developing aluminium-related syndromes, such as dialysis encephalopathy and osteomalacia. A statistical retrospective study on 253 uremic subjects was carried out to verify the predictive value of serum aluminium levels on bone aluminium accumulation. Serum and bone samples collected at the same time were analyzed for aluminium content. Analyses were performed by graphite furnace atomic absorption technique. The results verified bone aluminium concentrations of less than or equal to 60 mg/kg d.w. (dry weight) in 144 patients and greater concentrations in 109 patients. The statistical discriminant analysis showed that serum levels can be predictive in aluminium bone accumulation (lower or greater than 60 mg/kg) with about a 7% margin of error. This value may be further reduced to about 2% if two threshold limits are used (53-81 micrograms/l). The specificity and sensitivity of the test were 89.6% and 83.5%, respectively.