A different interaction between parathyroid hormone, calcitriol and serum aluminum in chronic kidney disease; a pilot study.

BACKGROUND/AIMS: Aluminum (Al) is an ingredient of a variety of foodstuffs and medications as well as of domestic water supplies. The patients with chronic kidney disease (CKD) are more susceptible to bone toxicity of Al. The aim of the study was to investigate the interactions between serum Al, parathyroid hormone (PTH) and active vitamin-D in CKD.

METHODS

A total of 10 pediatric patients with CKD and 20 healthy controls were enrolled in study. The blood calcium, aluminum, PTH, alkaline phosphatase and phosphorus were evaluated at onset and following a regimen of oral 1,25 dihydroxycholecalciferol (1,25 DHC) for 4 weeks.

RESULTS

Although median values of PTH, calcium, phosphorus and alkaline phosphatase did not differ (P > 0.05) after calcitriol administration, the aluminum levels (median: 27.2 ng/ml, range: 11.3-175) declined significantly (median: 3.8 ng/ml, range: 0.64-11.9) after a regimen of oral 1,25 DHC for 4 weeks in all participants (P < 0.05). The median levels of aluminum after 1,25 DHC did not show statistically significant difference with median aluminum levels of healthy controls (median: 2.5 ng/ml, range: 0.2-33.2) (P < 0.05).

CONCLUSION

Calcitriol may lead to decline in serum Al levels in CKD patients.