Gastrointestinal Absorption and Urinary Excretion of Aluminium in Patients with Predialysis Chronic Renal Failure

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Abstract
In a randomized cross-over study, serum and urinary aluminum (Al) was measured in 8 patients with predialysis chronic renal failure. Samples were taken after ingestion of an Al-containing phosphate binder (ACPB) with either water or 7% citric acid, and Al was analyzed by electrothermal atomic absorption spectrometry. Both serum levels and urinary excretion of Al increased markedly after ingestion of ACPB with citric acid. Only urinary Al excretion increased significantly after ACPB with water. Citric acid alone caused to change in serum concentration or urinary excretion of Al. The serum Al increase after ACPB with citric acid indicates that absorption of Al is taking place in both upper and lower intestines. Marked individual variations in gastrointestinal Al absorption, independent of kidney function, were seen after intake of ACPB with citric acid. These variations could not be predicted from changes in serum concentrations or from urinary excretion of Al after intake of ACPB with water. Intake of ACPB caused a significant decrease in serum phosphate.