Aluminum-Related Bone Disease

Experimental Al administration to animals produces osteomalacia (Goodman 1986). Essentially all patients suffering from chronic renal failure exhibit some degree of renal osteodystrophy. In kidney disease there is a decreased 

Interestingly, Quarles found osteoblast cells in culture required serum for complete mitogenic action (Quarles et al. 1991). While he considered that this might be to trigger the signal transduction pathway (e.g., PTH contamination) an alternative possibility is that Tf inclusion in serum improved Al delivery to its intracellular site of action. Al modulation of G protein function is an attractive theory for the biphasic mechanism(s) of mitogenic action and inhibition (see Sect. G), particularly since Al could act alone or combined with F to have differing effects. 

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David-Neto E, Jorgetti V, Soeiro NMR, et al. 1993. Reversal of aluminum-related bone disease after renal transplantation. Am J Nephrol 13 12-17. 

D Haese PCD, Couttenye MM, Goodman WG, et al. 1995. Use of the low-dose desferrioxamine test to diagnose and differentiate between patients with aluminum-related bone disease, increased risk for aluminum toxicity, or aluminum overload. Nephrol Dial Transplant 10 1874-1884. 

Mazzaferro S, Coen G, Ballanti P, et al. 1992. Deferoxamine test and PTH serum levels are useful not to recognize but to exclude aluminum-related bone disease. Nephron 61 151-157. 

Sherrard DJ, Walker JV, Boykin JL. Precipitation of dialysis dementia by deferoxamine treatment of aluminum-related bone disease. Am J Kidney Dis 1988 12(2) 126-30. 

Aluminum-related bone disease can be diagnosed and treated with deferoxamine, an avid chelator of both iron and Al. The deferoxamine infusion test is useful for the ultimate diagnosis of Al overload disease, and the drug has demonstrated utility for treating acute Al overload. ... 

Silicon and aluminum oxides and hydroxides are the most abundant compounds on our earth. They exist in rock, soil, the dust we breathe, and as components or trace components in just about all we touch or consume. Over decades, they have made their appearance in a number of segments of medicine such as fibrotic diseases, tumor induction, Alzheimer s disease, and aluminum related bone diseases. Of these Alzheimer s disease is perhaps one of the most serious diseases in our society. Here a still mysterious role of "aluminum" is observed and acknowledged by many researchers. 

Moriniere P, Cohen-Solal M, Belbrik S, Boudailliez B, Marie A, Westeel PF, Renaud H, Fievet P, Lalau JD, Sebert JL, et al. Disappearance of aluminic bone disease in a long term asymptomatic dialysis population restricting A1(0H)3 intake emergence of an idiopathic adynamic bone disease not related to aluminum. Nephron 1989 53(2) 93-101. 

Andress DL, Maloney NA, Coburn JW, Endres DB, Sherrard DJ. Osteomalacia and aplastic bone disease in aluminum-related osteodystrophy. J Chn Endocrinol Metab 1987 65(1) 11-16. 

Low-turnover bone diseases include osteomalacia and adynamic (also known as aplastic) bone diseases. Osteomalacia and adynamic bone disease are distinguished by the extent of unmineralized bone matrix or osteoid osteoid is increased in osteomalacia and normal or low in adynamic bone disease. Osteomalacia in chronic renal failure may reflect vitamin D deficiency because of the decreased renal synthesis of l,25(OH)2D (see Osteomalacia and Rickets) or aluminum-related disease. In the 1970s and 1980s, aluminum intoxication was a significant contributing factor to the development of osteomalacia and adynamic bone... 

As patients live longer with dialysis treatment, they begin to develop yet another set of problems related to dialysis itself, and to the chronic accumulation of endogenous compounds (p2-microglobulin) and exogenous toxins (aluminum). P2-Microglobulin causes dialysis amyloidosis with the carpal tunnel syndrome and destructive arthropathy. Aluminum causes anemia, osteomalacia or adynamic bone disease, and encephalopathy. 

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