혈액 투석환자에서 혈중 알루미늄 농도에 관한 임상적 고찰

Abstract

Purpose : This study was performed to evaluate the aluminum level in hemodialysis patients and to find a correlation between aluminum level and bone specific alkaline phosphatase level. Methods : Eighty five randomly selected patients with end-stage renal disease, undergoing maintenance hemodialysis treatment over 1 year were studied. Serum aluminum and bone specific alkaline phosphatase concentration were measured. Low dose desferrioxamine test (5 mg/kg) was done. Results : The serum aluminum concentration before and after low dose desferrioxamine test were 4.21±2.13 μg/L and 8.89±4.48 μg/L (p<0.01) respectively. Bone-specific alkaline phosphates and parathyroid hormone concentration were 39.08±39.90 mg/dL and 98.27±112.92 pg/mL. The aluminum level after desferrioxamine test was correlated with duration of hemodialysis (r=0.238, p=0.03). Aluminum level was not correlated with bone specific alkaline phosphatase level. Conclusion : Aluminum level was lower than that of previous studies. Aluminum level was not increased in patients with low bone specific alkaline phosphatase. Thus, it seems that serum aluminum level is not a major problem in hemodialysis patients with lower turnover bone disease. However, confirm diagnosis of aluminum related bone disease in hemodialysis patients needs combined study of bone histology with a large number of cases.