Hyperaluminémie des hémodialysés chroniques: évaluation du rôle respectif de l'aluminium du dialysat et de celui de la prise orale d'hydroxyde d'alumine

UNLABELLED: In order to evaluate the respective role of dialysate aluminium and of oral aluminium hydroxide in the occurrence of hyperaluminemia in patients on chronic hemodialysis, plasma aluminium was measured in 19 of them selected for their reliability, before and then 6 and 12 months after the use of a double step reverse osmosis system which allowed to have dialysate aluminium always below 20 micrograms/l, whereas before it was between 20 and 120 micrograms/l. No significant decrease of their plasma aluminium concentration was observed (81 +/- SEM 12, 81 +/- 12 and 75 +/- 12 micrograms/l respectively). But a significant correlation between plasma aluminium and the total or daily prescribed dose of Al (OH)3 was found before and after 12 months of reverse osmosis. A significant negative correlation was observed between plasma aluminium and the mean corpuscular volume, before and 12 months after reverse osmosis. No correlation was found between plasma aluminium and the plasma PTH levels or with the administration of active vitamin D metabolites. CONCLUSIONS: These data suggest that oral Al (OH)3 plays a predominant role in the hyperaluminemia of hemodialyzed patients and that hyperaluminemia may contribute to their microcytic anemia.