Monteagudo F S, Cassidy M J, Folb P I
Department of Pharmacology, Medical School, University of Cape Town, South Africa.
Med Toxicol Adverse Drug Exp. 1989 Jan-Feb;4(1):1-16. doi: 10.1007/BF03259899.
Aluminum is now recognised as an important toxin causing considerable morbidity and mortality, particularly in patients with chronic renal failure. Diseases that have been associated with aluminium include dialysis dementia, renal osteodystrophy and Alzheimer's disease. Aluminum also has an effect on red blood cells, parathyroid glands and chromosomes. Accumulation of aluminium in the body tends to occur when the gastrointestinal barrier is circumvented. This has been identified as a problem during dialysis or intravenous fluid administration. Renal functional impairment results in decreased aluminum excretion and promotes accumulation of the element in the body. Many sources have been shown to be contaminated with aluminium. These include the water used for dialysis; medicines containing aluminium, such as aluminium-containing phosphate binding gels; total parenteral nutrition solutions; processed human serum albumin; intravenous fluids in infants; and other environmental and industrial sources. The management of aluminium toxicity involves the identification of these contaminated sources and subsequent removal of the element. This includes regular monitoring of water used in dialysis. The use of aluminium-containing phosphate binding gels in patients with compromised renal function should be reviewed and alternatives sought. The development of effective aluminium-free phosphate binders is desirable. Once a patient has aluminium toxicity, desferrioxamine (deferoxamine) has been shown to be an effective agent in its chelation and removal.
铝现在被认为是一种重要的毒素，会导致相当高的发病率和死亡率，尤其是在慢性肾衰竭患者中。与铝相关的疾病包括透析性痴呆、肾性骨营养不良和阿尔茨海默病。铝对红细胞、甲状旁腺和染色体也有影响。当胃肠道屏障被绕过，体内就容易发生铝蓄积。这已被确定为透析或静脉输液过程中的一个问题。肾功能损害会导致铝排泄减少，并促进体内该元素的蓄积。已证明许多来源都被铝污染。这些包括用于透析的水；含铝药物，如含铝的磷酸盐结合凝胶；全胃肠外营养溶液；加工过的人血清白蛋白；婴儿静脉输液；以及其他环境和工业来源。铝中毒的处理包括识别这些污染源并随后去除该元素。这包括定期监测透析用水。对于肾功能受损患者使用含铝的磷酸盐结合凝胶的情况应进行审查并寻找替代方法。开发有效的无铝磷酸盐结合剂是很有必要的。一旦患者出现铝中毒，去铁胺已被证明是一种有效的螯合和去除剂。
