Aluminum overload in the reverse osmosis dialysis era: does it exist?
Mei-Yin Chen1,2, Shih-Hsiang Ou3,4, Nai-Ching Chen5
1Department of Nutrition and Food Service, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Renal Failure
|October 3, 2022
Summary
Aluminum overload persists in dialysis patients despite modern hemodialysis. Monitoring serum aluminum is crucial, especially when using aluminum-based phosphate binders, due to non-obvious symptoms like anemia.
Area of Science:
- Nephrology
- Clinical Chemistry
Background:
- Aluminum accumulation is a known complication in dialysis patients.
- Hemodialysis advancements may reduce aluminum overload, but evidence is limited.
- Aluminum binders and dialysis fluid treatments might impact aluminum levels.
Purpose of the Study:
- To evaluate the prevalence of aluminum overload in dialysis patients using the desferrioxamine (DFO) test.
- To record the presentation and treatment of aluminum overload in this cohort.
Main Methods:
- Retrospective analysis of electronic records from January 2014 to June 2020.
- Inclusion of 99 dialysis patients undergoing DFO testing for aluminum overload.
- Recording of patient symptoms, laboratory results, and treatment outcomes.
Main Results:
- 47.5% of patients tested positive for aluminum overload.
- Symptoms included unexplained anemia, fractures, and hypercalcemia; encephalopathy was absent.
- Treatment for aluminum overload led to decreased erythropoietin doses and lower alkaline phosphatase levels.
Conclusions:
- Aluminum overload remains a concern in the era of reverse osmosis dialysis.
- Non-obvious symptoms like anemia warrant monitoring of serum aluminum.
- Monitoring is recommended for dialysis patients using aluminum-based phosphate binders.
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