Demontis R, Leflon A, Fournier A, Tahiri Y, Herve M, Moriniere P, Abdull-Massih Z, Atik H, Belbrik S, Renaud H
Clin Nephrol. 1986 Sep;26(3):146-9.
1 alpha(OH) vitamin D3 at the dose of 6 micrograms per week was given for 4 weeks to 16 stable patients on chronic hemodialysis with a low dialysate aluminum while taking a constant dose of Al(OH)3. A significant increase of their plasma aluminum was observed from 1.2 +/- .25 mumol/l before 1 alpha(OH)D3 to 1.7 +/- .35 during the second fortnight of 1 alpha(OH)D3 administration and this increase surprisingly was maintained at 1.71 +/- .3 up to 6 weeks after 1 alpha(OH)D3 discontinuation. Increases in plasma calcium and decreases in plasma PTH were observed during 1 alpha(OH)D3 administration and these changes were correlated to the changes in plasma aluminum. It is concluded that the increase in plasma aluminum observed with 1 alpha(OH)D3 and after its discontinuation is either due to body aluminum burden redistribution or to increased aluminum intestinal absorption whatever the mechanism is, this effect should lead to close monitoring of plasma aluminum in uremic patients taking 1 alpha OH vitamin D3.
每周给予16例慢性血液透析稳定患者6微克剂量的1α(OH)维生素D3,持续4周,这些患者透析液铝含量低,同时服用恒定剂量的氢氧化铝。观察到他们的血浆铝显著增加,从服用1α(OH)D3前的1.2±0.25微摩尔/升增加到服用1α(OH)D3第二周的1.7±0.35微摩尔/升,令人惊讶的是,在停用1α(OH)D3后6周,这一增加仍维持在1.71±0.3。在服用1α(OH)D3期间观察到血浆钙增加和血浆甲状旁腺激素降低,这些变化与血浆铝的变化相关。得出的结论是,服用1α(OH)D3时及停药后观察到的血浆铝增加,要么是由于体内铝负荷重新分布,要么是由于铝的肠道吸收增加,无论其机制如何,这种效应都应导致对服用1α-OH维生素D3的尿毒症患者的血浆铝进行密切监测。