Aluminium toxicity in people on dialysis

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Aluminium toxicity in people on dialysis
Synonyms Dialysis-related aluminium toxicity
Pronounce N/A
Specialty Nephrology
Symptoms Bone pain, muscle weakness, anemia, encephalopathy
Complications Osteomalacia, dementia, fractures
Onset Gradual
Duration Chronic
Types N/A
Causes Aluminium exposure from dialysis
Risks Long-term dialysis, use of aluminium-containing phosphate binders
Diagnosis Blood test for aluminium levels, bone biopsy
Differential diagnosis Hyperparathyroidism, osteoporosis, iron deficiency anemia
Prevention Use of aluminium-free dialysis solutions, monitoring of aluminium levels
Treatment Deferoxamine therapy, switching to aluminium-free phosphate binders
Medication N/A
Prognosis Variable, depends on early detection and treatment
Frequency Rare, due to improved dialysis techniques
Deaths N/A


Aluminium toxicity is a medical condition that occurs when an individual is exposed to high levels of aluminium. This condition is particularly prevalent among individuals undergoing dialysis, a medical procedure used to remove waste and excess water from the blood in people whose kidneys can't perform these functions naturally.

Causes

The primary cause of aluminium toxicity in dialysis patients is the use of aluminium-based phosphate binders and the contamination of dialysis solutions with aluminium. The use of aluminium-containing antacids and other medications can also contribute to the accumulation of aluminium in the body.

Symptoms

The symptoms of aluminium toxicity can vary depending on the level of exposure and the individual's overall health. Common symptoms include bone pain, anemia, neurological disorders, and dementia. In severe cases, aluminium toxicity can lead to encephalopathy, a broad term for any brain disease that alters brain function or structure.

Diagnosis

Diagnosis of aluminium toxicity is often challenging due to the nonspecific nature of the symptoms. However, it can be suspected in dialysis patients who present with unexplained anemia, bone disease, or encephalopathy. The diagnosis can be confirmed by measuring the levels of aluminium in the blood or bone.

Treatment

The primary treatment for aluminium toxicity is to reduce exposure to aluminium. This can be achieved by using non-aluminium based phosphate binders and ensuring that dialysis solutions are free from aluminium contamination. In some cases, a procedure called desferrioxamine infusion may be used to remove aluminium from the body.

Prevention

Prevention of aluminium toxicity involves careful monitoring of aluminium levels in dialysis patients and the use of aluminium-free products whenever possible. Regular monitoring of aluminium levels in the blood can help detect the condition early and prevent its progression.

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Contributors: Prab R. Tumpati, MD