Document Detail

Evidence of aluminum loading in infants receiving intravenous therapy.
MedLine Citation:
PMID:  3921839     Owner:  NLM     Status:  MEDLINE    
To investigate the possibility that premature infants may be vulnerable to aluminum toxicity acquired through intravenous feeding, we prospectively studied plasma and urinary aluminum concentrations in 18 premature infants receiving intravenous therapy and in 8 term infants receiving no intravenous therapy. We also measured bone aluminum concentrations in autopsy specimens from 23 infants, including 6 who had received at least three weeks of intravenous therapy. Premature infants who received intravenous therapy had high plasma and urinary aluminum concentrations, as compared with normal controls: plasma aluminum, 36.78 +/- 45.30 vs. 5.17 +/- 3.1 micrograms per liter (mean +/- S.D., P less than 0.0001); urinary aluminum:creatinine ratio, 5.4 +/- 4.6 vs. 0.64 +/- 0.75 (P less than 0.01). The bone aluminum concentration was 10 times higher in infants who had received at least three weeks of intravenous therapy than in those who had received limited intravenous therapy: 20.16 +/- 13.4 vs. 1.98 +/- 1.44 mg per kilogram of dry weight (P less than 0.0001). Creatinine clearances corrected for weight did not reach expected adult values until 34 weeks of gestation. Many commonly used intravenous solutions are found to be highly contaminated with aluminum. We conclude that infants receiving intravenous therapy have aluminum loading, which is reflected in increased urinary excretion and elevated concentrations in plasma and bone. Such infants may be at high risk for aluminum intoxication secondary to increased parenteral exposure and poor renal clearance.
A B Sedman; G L Klein; R J Merritt; N L Miller; K O Weber; W L Gill; H Anand; A C Alfrey
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The New England journal of medicine     Volume:  312     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  1985 May 
Date Detail:
Created Date:  1985-06-10     Completed Date:  1985-06-10     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1337-43     Citation Subset:  AIM; IM    
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MeSH Terms
Aluminum / metabolism*,  poisoning
Bone and Bones / analysis
Creatinine / metabolism
Drug Contamination
Infant, Newborn
Infant, Premature*
Parenteral Nutrition / adverse effects*
Prospective Studies
Grant Support
Reg. No./Substance:
60-27-5/Creatinine; 7429-90-5/Aluminum

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

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