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Aluminum associated bone disease: clinico-pathologic correlation

B Ihle, M Buchanan, B Stevens

    American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
    |September 1, 1982
    PubMed
    Summary
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    Aurine tricarboxylic acid staining identified aluminum in bone for chronic renal failure patients with osteomalacia. This method aids in diagnosing early-stage aluminum-related bone disease.

    Area of Science:

    • Bone histopathology
    • Toxicology
    • Nephrology

    Background:

    • Aluminum accumulation in bone is a concern for patients with chronic renal failure.
    • Severe osteomalacia can be linked to elevated aluminum levels in bone tissue.

    Purpose of the Study:

    • To evaluate the efficacy of aurine tricarboxylic acid staining for detecting aluminum in bone.
    • To correlate staining results with histopathological and biochemical markers of hyperparathyroidism.

    Main Methods:

    • Bone biopsies were stained using aurine tricarboxylic acid.
    • Positive staining sites were confirmed with electron dispersion x-ray analysis.
    • Patients were assessed for biochemical and histological features of hyperparathyroidism.

    Main Results:

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    • Twenty-six percent of patients (13/49) showed positive aluminum staining at the bone-osteoid junction.
    • Patients with negative staining but high bone aluminum exhibited more severe hyperparathyroidism.
    • Electron dispersion x-ray analysis confirmed aluminum presence.

    Conclusions:

    • Aurine tricarboxylic acid staining is a useful clinical tool for identifying bone aluminum.
    • The technique can aid in the diagnosis of presymptomatic aluminum-related osteomalacia.
    • Staining results provide insights into the relationship between aluminum deposition and hyperparathyroidism severity.