QUANTITATION AND LOCALIZATION OF ALUMINUM IN HUMAN CANCELLOUS BONE IN RENAL OSTEODYSTROPHY

  • 1 January 1981
    • journal article
    • research article
    • p. 329-337
Abstract
Al toxicity may be responsible for a type of vitamin D-resistant osteomalacia and a unusually severe form of dementia (dialysis dementia) occurring in some patients with chronic renal failure on regular hemodialysis. High concentrations of Al have been found in blood, bone and brain tissue from these patients. Al comes either from the H2O used during dialysis (added in some public H2O supplies during purification to precipitate contaminants) or from aluminum salts taken orally to bind phosphates and so restrict their dietary absorption. Recent X-ray microanalytical studies demonstrated Al in lysosomes of cerebral cells and at the calcification front in bone of patients dying of dialysis dementia, but its concentration at this site in bone was not measured using this technique. Transiliac bone biopsies from 3 patients with dialysis dementia and 6 non-demented patients on regular hemodialysis were examined. Atomic absorption spectrometry (AAS) reveals high Al content in bone from the 3 demented and 2 of the non-demented patients. All had vitamin D-resistant osteomalacia. Using X-ray microanalysis Al was located in the bone of these 5 patients only. The Al had a highly focal distribution and was measured at up to 40 times higher concentration than by AAS but only in mineralization nuclei of the calcification front or less than 2 .mu.m into the mineralized bone. The study was done retrospectively on biopsies fixed in 10% buffered formalin, which eluted some of the Al. In life, Al levels may have been higher than those detected.