Meira Rodrigo Dias de, Carbonara Cinthia Esbrile Moraes, Quadros Kélcia Rosana da Silva, Santos Carolina Urbini Dos, Schincariol Patrícia, Pêssoa Gustavo de Souza, Arruda Marco Aurélio Zezzi, Jorgetti Vanda, Oliveira Rodrigo Bueno de
Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Medicina Interna, Campinas, SP, Brasil.
Universidade Estadual de Campinas, Departamento de Medicina Interna (Nefrologia) - Faculdade de Ciências Médicas, Laboratório para o Estudo do Distúrbio Mineral e Ósseo em Nefrologia (LEMON), Campinas, SP, Brasil.
J Bras Nefrol. 2018 Apr-Jun;40(2):201-205. doi: 10.1590/2175-8239-JBN-3882. Epub 2018 Jun 4.
About four decades ago, the relationship between dialysis-dementia and aluminum (Al) began to be established. The restriction of drugs containing Al and improvements on water quality used for dialysis resulted in the clinical disappearance of Al intoxication. However, high prevalence of Al deposition in bone tissue from Brazilian dialysis patients is still being detected. Through the case report of a patient on hemodialysis (HD) for one year, presenting significant Al deposition in bone tissue, we speculated if this problem is not being underestimated. We used extensive investigation to identify potential sources of Al exposure with a careful review of medication history and water quality controls. Al concentration was measured by different methods, including mass spectrometry, in poly-electrolyte concentrate solutions and solution for peritoneal dialysis, in an attempt to elucidate the possible sources of contamination. The objective of this case report is to alert the medical community about a potential high prevalence of Al deposition in bone tissue and to discuss the possible sources of contamination in patients with chronic kidney disease (CKD).
大约四十年前，透析性痴呆与铝（Al）之间的关系开始被确立。限制含铝药物以及改善透析用水质量导致了铝中毒在临床上的消失。然而，巴西透析患者骨组织中铝沉积的高发生率仍被检测到。通过对一名接受血液透析（HD）一年且骨组织中有大量铝沉积的患者的病例报告，我们推测这个问题是否未被低估。我们进行了广泛调查，通过仔细回顾用药史和水质控制来确定铝暴露的潜在来源。采用不同方法测量了聚电解质浓缩液和腹膜透析液中的铝浓度，包括质谱法，以试图阐明可能的污染来源。本病例报告的目的是提醒医学界注意骨组织中铝沉积可能存在的高发生率，并讨论慢性肾脏病（CKD）患者中可能的污染来源。
