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Related Concept Videos

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Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
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Bone aluminum accumulation in the current era.

Rodrigo Bueno de Oliveira1,2, Aluízio Barbosa Carvalho3, Vanda Jorgetti4

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Aluminum accumulation in bone is surprisingly common in dialysis patients with chronic kidney disease (CKD). This bone aluminum may independently increase the risk of major adverse cardiovascular events, challenging global perceptions.

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Area of Science:

  • Nephrology
  • Toxicology
  • Cardiovascular Medicine

Background:

  • Evidence from the Brazilian Registry of Bone Biopsy (REBRABO) indicates a high incidence of aluminum (Al) accumulation in the bones of patients undergoing dialysis for chronic kidney disease (CKD).
  • This finding is unexpected given the global perception of epidemiologic control over aluminum-related conditions.

Discussion:

  • This paper explores reasons why aluminum accumulation in bone may not be diagnosed or reported in other regions.
  • It considers why bone aluminum accumulation persists, diverging from historical presentations as a classical intoxication syndrome with systemic signs.

Key Insights:

  • Bone aluminum accumulation in CKD patients on dialysis is more prevalent than previously thought.
  • Aluminum in bone may be an independent risk factor for major adverse cardiovascular events in this population.
  • Current diagnostic and reporting practices may underestimate the extent of this condition worldwide.

Outlook:

  • Further research is needed to understand the mechanisms linking bone aluminum to cardiovascular risk in CKD patients.
  • Re-evaluation of diagnostic criteria and surveillance for aluminum accumulation in CKD patients globally is warranted.
  • Investigating the source and management of aluminum exposure in dialysis patients is crucial for improving cardiovascular outcomes.