Document Detail


Aluminium-related osteodystrophy and desferrioxamine treatment: role of phosphorus.
MedLine Citation:
PMID:  7970094     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We investigated (1) the prevalence of aluminium overload among 96 patients with symptomatic bone disease haemodialysed from 1987 to 1989 in the Sao Paulo area, Brazil; (2) the effect of 6 months desferrioxamine (DFO) treatment (1-2g/week). All patients underwent a first bone biopsy. Aluminium overload (extent of stainable bone aluminium more than 20% trabecular surface) was observed in 74 of 96 patients. Forty overloaded patients were divided into patients with high bone formation rate (BFR) (group 1; n = 17) and patients with low BFR (group 2; n = 23), and had a second biopsy after DFO therapy. In both groups aluminium surface was reduced after treatment (P < 0.001), osteoblast surface (P < 0.02-P < 0.01) and plasma parathyroid hormone (iPTH) (P < 0.01) increased. In group 1 BFR remained high. In group 2 BFR remained low in 16 patients (2a) and increased in seven (P < 0.02) (2b). In group 2a plasma phosphorus was below that in group 2b patients, before (P < 0.03) and after (P < 0.01) DFO. The histological features of group 2a patients resembled hypophosphataemic osteomalacia, those of group 2b patients aluminium osteodystrophy. These data show a high prevalence of aluminium overload in Brazilian patients. Low-dose DFO therapy was safe, decreased bone pain, prevented fractures, and reduced stainable bone aluminium. Bone lesions only partially improved, suggesting that low phosphorus intake and/or plasma calcitriol concentrations may have prevented improvement of bone formation and mineralization.
Authors:
V Jorgetti; N M Soeiro; V Mendes; R C Pereira; M E Crivellari; G Coutris; A Borelli; M O Leite; I Nussenzweig; M Marcondes
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  9     ISSN:  0931-0509     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  1994  
Date Detail:
Created Date:  1994-11-29     Completed Date:  1994-11-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  668-74     Citation Subset:  IM    
Affiliation:
Laboratorie de Fisiopatologia Renal, Facultade de Medicina, Universidade de Sao Paulo, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Alkaline Phosphatase / blood
Aluminum / analysis*,  blood
Bone Remodeling / drug effects*
Calcium / blood
Deferoxamine / therapeutic use*
Female
Humans
Ilium / chemistry,  pathology*
Male
Middle Aged
Parathyroid Hormone / blood
Phosphorus / blood,  metabolism*
Renal Dialysis / adverse effects
Renal Osteodystrophy / blood,  drug therapy,  etiology*
Chemical
Reg. No./Substance:
0/Parathyroid Hormone; 70-51-9/Deferoxamine; 7429-90-5/Aluminum; 7440-70-2/Calcium; 7723-14-0/Phosphorus; EC 3.1.3.1/Alkaline Phosphatase

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