Desferrioxamine therapy in hemodialysis patients with aluminum-associated bone disease

Abstract

Aluminum toxicity in dialysis patients is associated with decreased bone turnover and a relative parathyroid hormone (PTH) deficiency. Desferrioxamine (DFO), a chelating agent, has been reported to improve bone histology in aluminum associated, low turnover bone disease in dialysis patients not subjected to parathyroidectomy. Information on the effect of DFO therapy on parathyroid gland function is lacking. In the present study, in addition to changes in bone histology, parathyroid gland function was evaluated in 18 hemodialysis patients with aluminum associated, low turnover bone disease (osteomalacia and aplastic bone disease) before and after one year of DFO treatment (1 to 6 g/week). Parathyroid gland function was assessed by using a calcium free and high calcium (3.5 to 4 mEq/liter) hemodialysis bath.(ABSTRACT TRUNCATED AT 250 WORDS)

Systemic Aluminum Toxicity: Effects on Bone, Hematopoietic Tissue, and Kidney

“…Possibly the "stable" Al may have been laid down in cortical bone and have an extended half-life because of slower turnover of cortical bone compared to trabecular bone. In support of this theory, desferrioxamine therapy reduced stainable trabecular bone surface Al from 44 to 13% in hemodialysis patients (Felsenfield et al, 1989). Furthermore, stainable Al at the bone surface, but not total bone Al, was found to correlate with extent of osteomalacia (Faugere & Malluche, 1986).…”

Intoxicação alumínica na DRC

“…43 O controle do tratamento pode ser feito por meio do teste de desferroxamina ou da biópsia óssea. [44][45][46] …”

Effect of Desferrioxamine in Acute Haemolytic Anaemia of Glucose-6-Phosphate Dehydrogenase Deficiency

“…DFO is widely used as a chelating agent in iron and aluminum overload [10, 11]. A single dose of DFO up to 6 g was well tolerated with no ill effects of a subjective nature [12, 13].…”