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Published on: September 20, 2019
Aluminum loading during total parenteral nutrition
The American Journal of Clinical Nutrition
|June 1, 1982
Summary
Long-term total parenteral nutrition (TPN) can elevate aluminum (Al) levels in patients, particularly in bone. Replacing casein with amino acids in TPN solutions reduced Al levels, suggesting casein as the source.
Area of Science:
- Clinical Nutrition
- Toxicology
- Bone Metabolism
Background:
- Long-term total parenteral nutrition (TPN) is a critical intervention for patients unable to receive nutrition orally.
- Concerns exist regarding the potential accumulation of aluminum (Al) from TPN solutions and its impact on patient health.
- Aluminum contamination in TPN has been linked to various adverse effects, including bone disease.
Purpose of the Study:
- To investigate the source of elevated aluminum (Al) levels in patients receiving long-term TPN.
- To determine the effect of substituting casein with amino acids in TPN solutions on Al levels.
- To assess the relationship between parenteral Al loading and tissue Al accumulation, especially in bone.
Main Methods:
- Patients on long-term TPN were assessed for aluminum (Al) levels in plasma and bone.
- The TPN solutions were analyzed to identify the source of Al.
- A dietary intervention involved substituting casein with amino acids in TPN, and subsequent changes in urinary and plasma Al were monitored.
Main Results:
- Elevated aluminum (Al) levels were detected in the bone and plasma of patients on long-term TPN.
- Casein, a component of the TPN solution, was identified as the source of Al.
- Substitution of casein with amino acids led to a significant decrease in urinary and plasma Al levels.
Conclusions:
- Parenteral administration of aluminum (Al) via TPN leads to increased tissue Al burden, notably in bone.
- The use of casein in TPN solutions is a likely contributor to aluminum accumulation.
- Prolonged use of casein-containing TPN solutions may pose risks and warrants careful consideration.
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