Absorption aluminum

Solutions that contain sodium citrate/citric acid (Shohl s solution and Bicitra) provide 1 mEq/L (1 mmol/L) each of sodium and bicarbonate. Polycitra is a sodium/potassium citrate solution that provides 2 mEq/L (2 mmol/L) of bicarbonate, but contains 1 mEq/L (1 mmol/L) each of sodium and potassium, which can promote hyperkalemia in patients with severe CKD. The citrate portion of these preparations is metabolized in the liver to bicarbonate, while the citric acid portion is metabolized to C02 and water, increasing tolerability compared to sodium bicarbonate. Sodium retention is also decreased with these preparations. However, these products are liquid preparations, which may not be palatable to some patients. Citrate can also promote aluminum toxicity by augmenting aluminum absorption in the GI tract. 

Calcium acetate (PhosLo) - Control of hyperphosphatemia in end-stage renal failure does not promote aluminum absorption. 

The influence of some of the aforementioned factors on aluminum absorption is further illustrated by the findings of two animal studies which estimated bioavailability differences by comparing areas under plasma concentration-time curves (AUC) after oral and intravenous dosing (Yokel and McNamara 1988). Using a single oral dose of aluminum chloride, aluminum absorption was estimated to be 0.57% in... 

No studies were located regarding aluminum absorption in humans after dermal exposure to aluminum or its compounds. Aluminum compounds are common additives in underarm antiperspirants. The active ingredient is usually an aluminum chlorhydrate salt, which is thought to form an obstructive plug of aluminum hydroxide within the sweat duct (Reiber et al. 1995). The possibility that aluminum in antiperspirants may be absorbed directly through the skin has been suggested (Graves et al. 1990), but this hypothesis has not been clinically confirmed. 

As discussed in Section 2.4.1, there are some data that suggest that aluminum absorption can be enhanced by parathyroid hormone and vitamin D, but the data are inconclusive. 

There are limited data on reducing aluminum absorption following exposure. There is good evidence that aluminum is absorbed by a pericellular energy-independent and sodium-dependent process (Provan and Yokel 1988). If this is correct, then treatments that block pericellular processes can be used to minimize or prevent intestinal uptake of aluminum. 

Sakhaee K Aluminum absorption - effects of calcium citrate on aluminum-containing antacids University of Texas SW Med. Center National Center for Research Resources... 

University of Texas Southwest Medical Center, Dallas, TX A project on aluminum absorption and the effect of calcium citrate on aluminum-containing antacids. The objective of this study is to determine whether calcium citrate given together with aluminum-containing antacids would enhance intestinal absorption of aluminum in humans. National Center for Research Resources... 

Becker RR, Blotcky AJ, Leffler JA, et al. 1977. Evidence for aluminum absorption from the gastrointestinal tract and bone deposition by aluminum carbonate ingestion with normal renal function. J Lab Clin Med 90 810-815. 

Cobum JW, Mischel MG, Goodman WG, et al. 1991. Calcium citrate markedly enhances aluminum absorption from aluminum hydroxide. Am J Kidney Dis 17 708-711. 

Domingo JL, Gomez M, Llobet JM, et al. 1991. Influence of some dietary constituents on aluminum absorption and retention in rats. Kidney Int 39 598-601. 

Fairweather-Tait S, Hickson K, McGaw B, et al. 1994. Orange juice enhances aluminum absorption from antacid preparation. Eur J Clin Nutr 48 71 -73. 

Feinroth M, Feinroth MV, Berlyne GM. 1982. Aluminum absorption in the rat everted gut sac. Miner Electrolyte Metab 8 29-35. 

Liss L, Thornton DJ. 1986. The rationale for aluminum absorption control in early stages of Alzheimer s disease. Neurobiol Aging 7 552-554. 

Main J, Ward MK. 1992. Potentiation of aluminum absorption by effervescent analgesic tablets in a haemodialysis patient. Br Med J 304 1686. 

Slanina P, Freeh W, Bemhardson A, et al. 1985. Influence of dietary factors on aluminum absorption and retention in the brain and bone of rats. Acta Pharmacol Toxicol 56 331-336. 

Testolin G, Erba D, Ciappellano S, et al. 1996. Influence of organic acids on aluminum absorption and storage in rat tissues. Food Addit Contain 13 21-27. 

Whitehead MW, Farrar G, Christie GL, et al. 1997. Mechanisms of aluminum absorption in rats. Am J Clin Nutr 65 1446-1452. 

Woodward-Knight L, Fudge A, Teubner J, et al. 1992. Aluminum absorption and antacid therapy in infancy. J Paediatr Child Health 28 257-259. 

Calcium channels are suggested to mediate intestinal aluminum absorption [84]. Aluminum distributes unequally to all tissues. The values given for the aluminum levels in the human body vary widely. Under normal conditions the aluminum concentration in blood is 5-10 pmol L-1 [14, 85]. The mean aluminum concentration in human milk was 23.4 9.6 pg L-1 and did not differ significantly between colostrum, intermediate-stage, and mature-stage milk [86]. 

Citric acid and citrates also enhance intestinal aluminum absorption in renal patients, which may lead to increased. 

Citrates and citric acid enhance intestinal aluminum absorption in renal patients, which may lead to increased, harmful serum aluminum levels. It has therefore been suggested that patients with renal failure taking aluminum compounds to control phosphate absorption should not be prescribed citrate-or citric acid-containing products. ... 

Furthermore, certain factors may increase intestinal aluminum absorption. We have previously described severe hyperaluminemia resulting in an acute rapidly fatal encephalopathy in four uremic patients who had been taking aluminum hydroxide and Shohl s solution, an alkalinizing buffer of sodium citrate and citric acid. The encephalopathy resembled the earlier dialysis dementia of the 1970s, but was much more acute, culminating in death within 3 weeks (B4, B5). 

The chemical form of aluminum affects aluminum absorption. Furthermore, the parathyroid hormones, vitamin D and iron seem to affect aluminum absorption."" In the human bloodstream aluminum is stored mainly in the Uver, kidneys, spleen, bones, and heart and brain tissues. 

Walker JA, Sherman RA, Cody RP. The effect of oral bases on enteral aluminum absorption. Arch Intern Med (1990) 150,2037-9. 

---