Treatment of aluminium intoxication: a new scheme for desferrioxamine administration

In order to control aluminium toxicity in dialysis patients it is preferable to prevent or limit exposure to it. However, it is sometimes necessary to remove the aluminium by the use of appropriate techniques. The collateral effects of desferrioxamine have led us to test new forms of administering desferrioxamine and attempt to reduce the dose. The aim of this study was to compare the removal of aluminium by administration of 15 mg/kg of desferrioxamine under two different schemes, that is, 44 h before the dialysis (classic scheme) and 1 h before dialysis (new scheme). The study was carried out in 10 patients over a period of 4 weeks. Aluminium removal was quantified in the dialysate throughout the dialysis. Measurement was also performed of the serum aluminium changes that occurred during the study. The total removal of aluminium was determined over three consecutive dialysis sessions following the administration of desferrioxamine. A similar amount of aluminium was found under both schemes. However, in the case of those patients given desferrioxamine 1 h prior to dialysis, removal of aluminium induced significantly lower serum aluminium peaks: (P < 0.02). These results suggest that the administration of desferrioxamine 1 h before dialysis is a valid alternative to the classic scheme (44 h before). The removal of aluminium at lower increments in the serum aluminium entails less risk for patients.