Gastrointestinal Absorption of Aluminum from Aluminum-Containing Antacids

Kaehny, William D.; Hegg, Arlene P.; Alfrey, Allen C.

doi:10.1056/nejm197706162962407

Cited by 389 publications

(96 citation statements)

References 7 publications

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“…A value of less than 5 p,g for 24 h urinary excretion of aluminium was comparable with our previous findings (6.4 ± 4.5 jxg (Mauras et al, 1982) and 7.8 ± 3.2 ,ug (Mauras et al, 1983)) and with those of others (3 ± 16 ,ug (Kaehny et al, 1977) and 2.7 ± 2.0 p.g (Haram et al, 1987)). …”

Section: Discussionsupporting

confidence: 92%

“…The oral ingestion of aluminium salts by patients under haemodialysis, in particular to reduce hyperphosphoraemia, can also lead to aluminium poisoning (Boukari et al, 1978). A small proportion of the orally ingested aluminium is absorbed from the gastrointestinal tract and, in the absence of renal excretion or elimination of aluminium by dialysis, aluminium accumulates in the body (Kaehny et al, 1977;Recker et al, 1977).…”

Section: Introductionmentioning

confidence: 99%

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Plasma and urine aluminium concentrations in healthy subjects after administration of sucralfate [see comments]

Allain

Mauras

Krari

et al. 1990

Brit J Clinical Pharma

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1. Sucralfate (basic sucrose aluminium sulphate), a topical intestinal agent, was administered in suspension or granule form to 25 healthy subjects at a total dose of 4 g day‐1 for 21 days. Aluminium in plasma and 24 h urine samples was assayed before, during and after administration of sucralfate by inductively coupled plasma optical emission spectrometry. 2. Sucralfate produced significant increases in plasma and urine aluminium concentrations. On average, plasma aluminium increased from about 2 micrograms 1‐1 to more than 5 micrograms 1‐1 and 24 h urine aluminium increased from less than 5 micrograms to more than 30 micrograms. Both plasma and urine aluminium concentrations decreased rapidly after sucralfate was stopped. However, urinary aluminium concentrations remained higher than normal 5 and 10 days after discontinuation of sucralfate administration. Moreover subjects receiving sucralfate granules had significantly higher average urinary excretion of aluminium than subjects receiving the suspension. 3. The small but significant increase in plasma and urine aluminium following sucralfate administration in therapeutic doses may reflect intestinal absorption of aluminium. Although such absorption would appear to be moderate in healthy subjects, it is suggested that aluminium‐based treatments should be used only intermittently, especially in patients with renal disorders.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Plasma and urine aluminium concentrations in healthy subjects after administration of sucralfate [see comments]

Allain

Mauras

Krari

et al. 1990

Brit J Clinical Pharma

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“…However, serum Al concentration in these infants was normal. Serum Al concentration may not be as good an indicator of body burden of A1 as urinary A1 excretion or urinary Al : creatinine (Kaehny et al 1977;Sedman et al 1985). This is similar to the findings of Kaehny et al (1977) in adult volunteers consuming larger doses of Al-containing antacids.…”

Section: A R E T H E R E R I S K S P O S E D By a L U M I N I U M I Nsupporting

confidence: 81%

“…Other factors which may enhance A1 absorption include acidic pH, leading Kaehny et al (1977) to suggest that Al may be better absorbed in an acid environment, such as the stomach or proximal duodenum. Also, Nordal et al (1988) found that serum Al concentrations were higher in Oslo-area residents in the autumn regardless of Al intake and renal function.…”

Section: Oral-enteral a D M I N I S T R A T I O N Absorptionmentioning

confidence: 99%

Nutritional Aspects of Aluminium Toxicity

Klein

1990

Nutr. Res. Rev.

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Table 1. Parenteral sources of aluminium contamination A1 Wl) Source Casein hydrolysate (100 g/l) Crystalline amino acids (100 g/l) Potassium phosphate (3 mmol/l) Unspecified phosphate Potassium phosphate Potassium acid phosphate (136 g/l) Sodium phosphate (3 mmol/l) Calcium gluconate (100 g/l) Calcium glucoheptonate Normal serum albumin (250 g/l) Normal serum albumin (43 g/l) Plasmanate? (50 g/l) Heparin (lo00 u/ml) Factor VIII Factor IX Trace metal solutions Multivitamin infusion

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“…Clearly the gastric solubility of A1 depends largely on the form in which it is ingested. Aluminosilicates yield little soluble A1 even at acidic pH and A1 from these is not absorbed (Mauras et al 1983); dissolution and absorption from Al(OH)3 is variable but low (Kaehny et al 1977;Weberg & Berstad, 1986), while available at https://www.cambridge.org/core/terms. https://doi.org/10.1079/PNS19930056 absorption of A1 from soluble salts (e.g.…”

Section: Gastrointestinal Acidity and T H E Form O F Ingested Aluminiummentioning

confidence: 99%

The chemistry of aluminium in the gastrointestinal lumen and its uptake and absorption

Powell

Thompson

1993

Proc. Nutr. Soc.

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A large number of experimental studies have been carried out on the intestinal absorption and/or uptake of Al, and on the factors that affect this. However, apart from the well-known problems of contamination and the difficulty of analysis of Al, many of these studies have been flawed, particularly when experimental solutions have been used, since often it has not been realized that the A1 has precipitated at physiological pH. Other problems have included inappropriate use of buffers (such as containing phosphate) and extrapolation of results from unphysiologically high levels to dietary levels.Here we shall assess the chemistry, uptake and absorption of A1 from the gastrointestinal tract, and in particular consider the importance of dietary, rather than pharmacological, levels to which the general population is exposed.

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Gastrointestinal Absorption of Aluminum from Aluminum-Containing Antacids

Cited by 389 publications

References 7 publications

Plasma and urine aluminium concentrations in healthy subjects after administration of sucralfate [see comments]

Plasma and urine aluminium concentrations in healthy subjects after administration of sucralfate [see comments]

Nutritional Aspects of Aluminium Toxicity

The chemistry of aluminium in the gastrointestinal lumen and its uptake and absorption

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