Altmann P, Butter K C, Plowman D, Chaput de Saintonge D M, Cunningham J, Marsh F P
Department of Nephrology, London Hospital, United Kingdom.
Kidney Int. 1987 Nov;32(5):710-3. doi: 10.1038/ki.1987.264.
We investigated 106 home hemodialysis patients whose mean [+/- SEM] serum aluminum (Al) concentration was 60.9 +/- 4.1 micrograms/liter. Serum Al concentration was inversely related to daily urine output (r = -0.52, P less than 0.001). Urine volume and measurements of Al exposure were included in a multivariate analysis of serum Al concentration in the 62 patients whose urine output was greater than 10 ml/day. The multiple correlation coefficient (r) was 0.70 (P less than 0.001) and the percentage contributions to r2 (indicating the relative importance of each factor) were: urine output 57%, oral Al intake 36%, total dialysis hours 7%. The additional contribution from cumulative water Al was negligible. In a subgroup of 26 patients with a urine output exceeding 10 ml/day, urinary Al excretion averaged 15.4 micrograms/day, and renal Al clearance and serum Al concentration were inversely related (r = -0.69, P less than 0.001). We conclude that Al-containing phosphate binders were a more important source of Al than was dialysate in these patients and that residual renal function can reduce the severity of hyperaluminemia in hemodialysis patients.
我们对106名家庭血液透析患者进行了研究，这些患者的血清铝（Al）浓度均值为60.9±4.1微克/升（均值±标准误）。血清铝浓度与每日尿量呈负相关（r = -0.52，P<0.001）。在尿量大于10毫升/天的62名患者中，将尿量和铝暴露量的测量纳入血清铝浓度的多变量分析。多重相关系数（r）为0.70（P<0.001），对r2的贡献率（表明各因素的相对重要性）分别为：尿量57%，口服铝摄入量36%，总透析时长7%。累积水中铝的额外贡献可忽略不计。在尿量超过10毫升/天的26名患者亚组中，尿铝排泄平均为15.4微克/天，肾铝清除率与血清铝浓度呈负相关（r = -0.69，P<0.001）。我们得出结论，在这些患者中，含铝磷结合剂是比透析液更重要的铝来源，并且残余肾功能可降低血液透析患者高铝血症的严重程度。
