Gordillo-Paniagua G, Valencia-Mayoral P, Mercado L, Medina-Mercado M
Departamento de Investigaciones Nefrológicas, Hospital Infantil de México Federico Gómez, México, D.F.
Bol Med Hosp Infant Mex. 1990 May;47(5):336-41.
Bone disorders in 28 children with chronic renal failure exposed to aluminum intoxication were studied. All of the children were in the dialysis program. Aluminum blood levels were higher than normal in all of the children and without any correlation to the magnitude of hypocalcemia or with the increase of the parathormone, which were found in different amounts in all of the children. All of the children had various degrees of skeletal retardation and only one had pathological fractures. The bone biopsy showed hypocellular marrow, decreased osteoclastic activity in the majority of the cases same as trabecular mineralization, although the amount of osteoid was lacking in the trabeculae in the majority of the cases. The deposit of aluminum was detected in a great number of them. It is concluded that osteodystrophy recognizes a number of factors as may be hypocalcemia due to a decrease in the production of 1,25-cholecalciferol, an increase in the parathyroid hormone and the deposit of aluminum, coming mainly from water, in the trabeculae which interfere with the incorporation of calcium in the formation of new bone.
对28名患慢性肾衰竭且有铝中毒的儿童的骨病情况进行了研究。所有儿童均在接受透析治疗。所有儿童的血铝水平均高于正常，且与低钙血症的程度或甲状旁腺激素的升高均无关联，而所有儿童均有不同程度的低钙血症和甲状旁腺激素升高。所有儿童均有不同程度的骨骼发育迟缓，只有1名儿童发生病理性骨折。骨活检显示骨髓细胞减少，多数病例破骨细胞活性降低，与小梁矿化情况相同，不过多数病例小梁中类骨质数量不足。在很多病例中检测到了铝沉积。得出的结论是，骨营养不良受多种因素影响，可能是由于1,25 - 二羟胆钙化醇生成减少导致的低钙血症、甲状旁腺激素升高以及主要来自水的铝在小梁中的沉积，这些因素干扰了钙在新骨形成过程中的掺入。
