Parenteral nutrition neonatal aluminium

Calcium is normally considered to be safe in parenteral nutrition, and relatively high quantities are often included in neonatal and pediatric formulations. However, there is a risk of hjrpercalciuria. The pathogenesis of hjrpercal-ciuria is not readily explicable on the basis of endocrine or metabolic effects, but it has been postulated to be due to excessive calcium or vitamin D intake or aluminium overload. 

The actual aluminium contents in 40 neonatal parenteral nutrition solutions and 16 component products used in parenteral nutrition formulations have been determined and compared with the calculated amounts from manufacturers product labels, and ascertain whether the actual aluminium exposure exceeds the FDA recommended maximum [14 ]. The measured and calculated aluminium concentrations exceeded the FDA recommended safe... 

Musculoskeletal Bone area and bone mineral content in lumbar spine, hip, and whole body were measured with dual radiograph absorptiometry in 59 children aged 13-15 who had been bom preterm and randomly assigned standard or aluminium-depleted parenteral nutrition solutions during the neonatal period. Those who had been randomly assigned to standard parenteral nutrition solutions had lower lumbar spine bone mineral content, apparently explained by a reduction in bone size. In nonrandomized analyses, children who were exposed as neonates to aluminium above the median (55 micrograms/kg) had lower hip bone mineral content, independent of bone or body size. The authors concluded that neonates who are exposed to parenteral aluminium may have reduced lumbar spine and hip bone mass during adolescence, potential risk factors for later osteoporosis, and hip fracture. 

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