Document Detail

Aluminum in parenteral products: medical perspective on large and small volume parenterals.
MedLine Citation:
PMID:  2499667     Owner:  NLM     Status:  MEDLINE    
Bone abnormalities may complicate parenteral nutrition (PN) therapy given to patients. Bone disease, manifested by reduced bone formation and demineralization in adults, and poor mineralization in infants, is associated with bone aluminum accumulation at the mineralizing surface. Aluminum was first shown to contaminate casein hydrolysate, the PN protein source. Substitution of amino acid solutions, low in aluminum, reduced bone aluminum and improved bone formation in adults. Aluminum also accumulates ten-fold in the bones of premature infants receiving chronic PN. Present sources of aluminum in PN are calcium and phosphate salts, albumin, and heparin. Although increased bone aluminum in infants is not proven to cause disease, use of deferoxamine in one infant produced hypocalcemia. This suggested that chelation of bone aluminum by deferoxamine increased bone calcium uptake. Thus aluminum in bone may impair bone calcium uptake and may contribute to the pathogenesis of PN-related bone disease in infants. Another complication of PN therapy in infants is cholestatic liver disease, manifested by reduced bile flow, and, occasionally, gallstones. Aluminum has been found to accumulate in the livers of these infants, and there is experimental evidence that aluminum can reduce bile flow both in rats and in piglets. Aluminum contamination of PN solutions puts infants at increased risk for complications of PN therapy; amounts of aluminum in PN solutions should therefore be minimized.
G L Klein
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Journal of parenteral science and technology : a publication of the Parenteral Drug Association     Volume:  43     ISSN:  0279-7976     ISO Abbreviation:  J Parenter Sci Technol     Publication Date:    1989 May-Jun
Date Detail:
Created Date:  1989-07-27     Completed Date:  1989-07-27     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  8103145     Medline TA:  J Parenter Sci Technol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  120-4     Citation Subset:  IM    
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MeSH Terms
Aluminum / adverse effects*
Bone Diseases / chemically induced
Drug Contamination*
Drug-Induced Liver Injury
Infant, Newborn
Parenteral Nutrition, Total / adverse effects*
Grant Support
Reg. No./Substance:
0/Solutions; 7429-90-5/Aluminum

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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