Aluminum loading during total parenteral nutrition

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Abstract
Patients on long-term total parenteral nutrition were found to have elevated aluminum (Al) levels in bone, urine, and plasma, with the casein in the total parenteral nutrition solution the source of Al. Substitution of amino acids for casein was followed by a fall in urinary and plasma Al. Thus, parenteral loading with Al increases tissue Al, particularly in bone. Whether Al accumulation contributes to bone disease remains unclear, but the prolonged use of casein in total parenteral nutrition solutions may be inadvisable..