Turner M W, Ardila M, Hutchinson T, Prichard S, Barré P E, Beauvais J, Kaye M
Department of Medicine, Royal Victoria Hospital, Montreal, P. Quebec, Canada.
Am J Kidney Dis. 1988 Jan;11(1):51-6. doi: 10.1016/s0272-6386(88)80175-6.
Chronic dialysis patients at risk for aluminum osteomalacia in areas of low water-aluminum content are not well identified. We, therefore, studied retrospectively a cohort of 59 patients who underwent bone biopsy at two hospital-based dialysis centers in Montreal (water aluminum content less than 10 micrograms/L). Overall, 25% of patients biopsied had aluminum-related osteomalacia defined by aluminum staining of more than 30% of the trabecular surface and low levels of bone formation as measured by tetracycline labeling. Multiple linear regression analysis showed high predialysis serum creatinine (P less than .05) and the amount of aluminum prescribed per month (P less than .05) as the most important determinants of aluminum staining. We conclude that aluminum-related osteomalacia can be a frequent disease entity in areas of low water-aluminum content. Our findings also suggest predialysis serum creatinine and the amount of aluminum prescribed per month are risk factors for the development of aluminum-related osteomalacia. Though the relationship between serum creatinine and aluminum staining of trabecular bone is unclear, serum creatinine is probably a marker for adequacy of dialysis in these patients.
在水铝含量低的地区，有患铝相关性骨软化症风险的慢性透析患者尚未得到很好的识别。因此，我们对蒙特利尔两家医院透析中心的59例接受骨活检的患者进行了回顾性研究（水铝含量低于10微克/升）。总体而言，通过骨小梁表面30%以上的铝染色和四环素标记法测定的低骨形成水平定义，25%接受活检的患者患有铝相关性骨软化症。多元线性回归分析显示，透析前血清肌酐水平高（P<0.05）和每月铝的处方量（P<0.05）是铝染色的最重要决定因素。我们得出结论，在水铝含量低的地区，铝相关性骨软化症可能是一种常见的疾病实体。我们的研究结果还表明，透析前血清肌酐和每月铝的处方量是铝相关性骨软化症发生的危险因素。虽然血清肌酐与骨小梁铝染色之间的关系尚不清楚，但血清肌酐可能是这些患者透析充分性的一个指标。
