Koch H, Reich H, Franke D, Delling G
Monatsschr Kinderheilkd. 1986 May;134(5):279-81.
An infant with uremia due to congenital renal hypoplasia was treated with oral aluminum hydroxide for 9 months in an attempt to reduce hyperphosphatemia. An increasingly painful osteopathy with pathological fractures ensued with loss of thoracic wall stability and respiratory failure. Increased serum aluminium levels and histochemically proved deposits of aluminium at the mineralisation front between calcified and noncalcified osteoid were demonstrated. In the context of recent findings concerning aluminium bone toxicity it is beyond doubt that this phosphate binding agent was detrimental for this child. Though a low phosphate diet normalized hyperphosphatemia after aluminium hydroxide treatment had been stopped, no effect on the progressive osteopathy was observed. Since aluminium hydroxide as a phosphate binder can be replaced by calcium carbonate or a low phosphate diet at least in young children, it should not be further recommended in this age group. This seems especially important in nondialyzed patients.
一名因先天性肾发育不全导致尿毒症的婴儿接受了9个月的口服氢氧化铝治疗，以试图降低高磷血症。随后出现了日益疼痛的骨病并伴有病理性骨折，胸壁稳定性丧失和呼吸衰竭。血清铝水平升高，并且在钙化和未钙化类骨质之间的矿化前沿通过组织化学证实有铝沉积。鉴于最近关于铝骨毒性的研究结果，毫无疑问这种磷酸盐结合剂对这个孩子是有害的。尽管在停止氢氧化铝治疗后低磷饮食使高磷血症恢复正常，但对进行性骨病未观察到效果。由于氢氧化铝作为磷酸盐结合剂至少在幼儿中可以被碳酸钙或低磷饮食替代，因此在这个年龄组中不应再推荐使用。这在未透析患者中似乎尤为重要。
