Mayor G H, Burnatowska-Hledin M
Semin Nephrol. 1986 Dec;6(4 Suppl 1):1-4.
The dialysis encephalopathy syndrome is at once the most widely recognized and most severe manifestation of aluminum toxicity. Evidence linking this syndrome and aluminum intoxication is virtually incontrovertible. The syndrome is characterized by speech and motor difficulties, dementia, and seizures. Less widely recognized symptoms include subtle changes in cognition and personality and directional disorientation. Since the widespread use of water treatment, aluminum exposure in the dialysis population has been primarily via intravenous (IV) medications and oral aluminum-containing, phosphate-binding antacid gels. In addition to the encephalopathy syndrome, aluminum has been linked to toxicity in bone, parathyroid gland, RBC, and kidney. These organ toxicities seem to be the result of specific protein enzyme inhibition. Currently identified factors that affect aluminum accumulation and modulate aluminum balance include uremia, renal function, parathyroid hormone withdrawal and suppression, 1,25-dihydroxycholecalciferol, and serum aluminum binding. Impaired renal function is not a prerequisite for increased tissue aluminum burdens. It is likely that aluminum-related disease will be increasingly observed in populations other than those with chronic renal failure.
透析性脑病综合征是铝中毒最广为人知且最为严重的表现形式。将该综合征与铝中毒联系起来的证据几乎是无可争议的。该综合征的特征为言语和运动障碍、痴呆以及癫痫发作。较少被广泛认识到的症状包括认知和性格的细微变化以及定向障碍。自从广泛采用水处理措施以来，透析人群中的铝暴露主要通过静脉内（IV）用药以及口服含铝的磷酸盐结合抗酸凝胶。除了脑病综合征外，铝还与骨骼、甲状旁腺、红细胞和肾脏的毒性有关。这些器官毒性似乎是特定蛋白质酶抑制的结果。目前已确定的影响铝蓄积和调节铝平衡的因素包括尿毒症、肾功能、甲状旁腺激素撤减和抑制、1,25 - 二羟胆钙化醇以及血清铝结合。肾功能受损并非组织铝负荷增加的先决条件。除了慢性肾衰竭患者外，其他人群中可能会越来越多地观察到与铝相关的疾病。
