Dialysis encephalopathy, bone disease and anaemia: the aluminum intoxication syndrome during regular haemodialysis.

Parkinson, Ian; Ward, M. K.; Kerr, David

doi:10.1136/jcp.34.11.1285

Cited by 262 publications

(82 citation statements)

References 41 publications

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“…The neurotoxicity of Al to patients with chronic renal disease is well established (Daugirdas, 1994), and its presence in the bloodstream leads to Al accumulation in bone and brain causing an encephalopathy called dementia dialytica. Several studies have pointed to Al as an exogen factor responsible for developed anemia signs both in experimental animals (Zaman et al, 1993;Fulton and Jeffery, 1994) and patients on hemodialysis (Parkinson et al, 1981). Al exposure increased delta-aminolevulinic acid dehydratase (delta-ALA-D) activity in bone marrow which promotes alterations on erythrocyte parameters in rats, probably as a consequence of alterations in the iron status (Farinaa et al, 2005).…”

Section: Aluminummentioning

confidence: 99%

Health Risk Assessment of Heavy Metals for Egyptian Population via Consumption of Poultry Edibles

Mahmoud¹

2015

Adv. Anim. Vet. Sci.

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| Exposure to heavy metals through poultry consumption may lead to health risks in Egypt, especially in areas with expanding industrial and agricultural activities. Lead (Pb), Cadmium (cd), Aluminum (Al) and Nickel (Ni) concentrations were determined in poultry muscle and liver using ZEEnit 700P Atomic Absorption Spectrophotometer with Graphite Furness. Mean concentrations of Pb and Cd in poultry muscle and liver exceeded the maximum tolerable limit set by the European communities. However, Al and Ni concentrations were below the guideline limits. According to the Egyptian standardization, only 33% and 66% of liver and muscle samples from Assiut exceeded the limit, respectively. The estimated weekly and daily intakes in the examined samples were below the FAO/WHO Guidelines limits. Meanwhile, Target Hazard Quotients (THQ) and Hazard Index (HI) were calculated to estimate the human health risk of Egyptian population. In this study, THQ and HI were more than 1 for Cd when compared with their reference dose (RfD) in poultry edibles from both Assiut and Qena. The study emphasizes the potential public health risk of Cd contamination from poultry consumption to the local inhabitants in Egypt.

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Section: Aluminummentioning

confidence: 99%

Health Risk Assessment of Heavy Metals for Egyptian Population via Consumption of Poultry Edibles

Mahmoud¹

2015

Adv. Anim. Vet. Sci.

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“…The realization that additional treatment was needed fi rst emerged in the late 1970s when a number of problems deriving from trace metal presence in the water were described [1,2] . This subsequently led to the development of national and international standards for water used in the preparation of dialysis fl uid defi ning the maximum permissible contaminant levels [3][4][5] .…”

Section: Water Quality In Haemodialysismentioning

confidence: 99%

The Importance of Water Quality and Haemodialysis Fluid Composition

Hoenich¹,

Ronco²,

Levin³

2005

Blood Purif

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Treatment of renal failure by haemodialysis uses dialysis fluid to facilitate the normalization of electrolyte and acid base abnormalities and the removal of low molecular weight uraemic compounds present in the plasma such as urea. The dialysis fluid is a continuously produced blend of treated tap water and a concentrated solution containing electrolytes, buffer, and glucose. The water used originates as drinking water but undergoes additional treatment. Recent surveys have indicated that the chemical and microbiological content of such water frequently fails to meet the requirements of established standards, and its bacterial content arising from the presence of a biofilm in the water distribution network or the hydraulic circuit of the dialysis machine is a contributory factor to the chronic inflammatory state in patients undergoing regular dialysis. The composition of the dialysis fluid plays an important role in the modulation of complications associated with end-stage renal disease, as well as those associated with the treatment itself. The avoidance of complications arising from water contaminants requires a constant and vigorous attention to water quality, whilst with the composition of electrolytes and buffer there is a trend towards greater individualization to provide a high degree of treatment tolerance.

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“…Aluminium toxicity has been a common problem in patients with chronic renal failure undergoing haemodialysis (Alfrey et al 1976;Ward et al 1978;Alfrey 1980;Parkinson et al 1981). While encephalopathy and anaemia have been observed as result of Al toxicity, the primary manifestation has been osteomalacic bone disease (Sideman & Manor 1982;Touam et al 1983;Llach et al 1986).…”

mentioning

confidence: 99%

Age‐Related Differences on Aluminium Mobilization by Chelating Agents in Aluminium‐Loaded Uraemic Rats

Esparza

Gómez

Domingo

et al. 2000

Pharmacology & Toxicology

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The efficacy of deferoxamine, deferiprone, and a combination of these chelating agents in the mobilization and promotion of aluminium (Al) excretion was compared in two age groups of uraemic rats which had previously received Al nitrate nonahydrate intraperitoneally in a daily dose of 45 mg/kg for 5 weeks. At the end of the period of Al exposure, Al-loaded rats of each age (young and adult) group were given one of the following treatments for 5 days: 0.90 mmol/kg/ day of deferoxamine (subcutaneously), 0.90 mmol/kg/day of deferiprone (orally), and 0.45 mmol/kg/day of deferoxamine (subcutaneously) plus 0.45 mmol/kg/day of deferiprone (orally). Control rats were given 0.9% saline (subcutaneously) and deionized water (orally). Total urines were collected 24 hr after each chelator administration. Although young rats treated with deferoxamine, deferiprone, or deferoxamine plus deferiprone showed significant increases in the total amount of Al excreted into urine during 5 consecutive days, the effect of combined administration of deferoxamine and deferiprone was lower than that caused by deferoxamine or deferiprone only. On the other hand, after administration of deferoxamine and deferiprone, a significant reduction of Al was noted only in the liver of young rats, while no significant effects of the chelators were seen in any of the examined tissues of adult animals. The results of the current study show that a combined therapy with deferoxamine and deferiprone (at half-doses of each drug) can also be effective in mobilizing Al from the body of Al-loaded uraemic rats.

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Dialysis encephalopathy, bone disease and anaemia: the aluminum intoxication syndrome during regular haemodialysis.

Cited by 262 publications

References 41 publications

Health Risk Assessment of Heavy Metals for Egyptian Population via Consumption of Poultry Edibles

Health Risk Assessment of Heavy Metals for Egyptian Population via Consumption of Poultry Edibles

The Importance of Water Quality and Haemodialysis Fluid Composition

Age‐Related Differences on Aluminium Mobilization by Chelating Agents in Aluminium‐Loaded Uraemic Rats

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