The use of chelating agents in the treatment of aluminum overload

Desferrioxamine (DFO), traditionally used as an iron chelator has been shown to increase urinary aluminum output in humans and aluminum-loaded mice, rats and rabbits. However, major side-effects of DFO treatment have been observed and the drug may accumulate in dialysis patients receiving repeated doses. In recent years, it has been reported that some dicarboxylic or tricarboxylic acids such as succinic, malic or citric may be considered as possible alternatives to DFO in the management of aluminum accumulation. Ethylene-di-(o-hydroxyphenylacetic acid)-like compounds may also have potential as alternatives to DFO in the treatment of aluminum accumulation and aluminum-induced toxicity. Investigation of new therapeutic agents with lower toxicity than DFO and clinical advantages in administration and cost is clearly encouraged.