Smith A J, Faugère M C, Abreo K, Fanti P, Julian B, Malluche H H
Am J Nephrol. 1986;6(4):275-83. doi: 10.1159/000167175.
To study aluminum-related bone disease, bone biopsies and serum biochemical measurements were done in 97 patients on maintenance dialysis and in 100 patients with mild to moderate renal failure. Bone histology, histochemical staining for aluminum and determination of bone aluminum content were done. Stainable bone aluminum was found in 50% of dialyzed patients and in 5% of nondialyzed patients. The finding of stainable bone aluminum in dialyzed patients was associated with high morbidity and mortality; it was not only seen in most patients with low turnover osteomalacia, but also in 47% of patients with mixed uremic osteodystrophy and in 1 patient with predominant hyperparathyroid bone disease. Patients with stainable aluminum had lower bone mass and decreased activity of bone-forming and -resorbing cells. Cumulative doses of aluminum-containing phosphate binders were a major risk factor. Aluminum in drinking water represents an additional risk factor. Neither serum biochemical tests nor single infusion of deferoxamine could be employed as diagnostic tools. Bone biopsies were the only means for diagnosis.
为研究铝相关性骨病，对97例维持性透析患者和100例轻至中度肾衰竭患者进行了骨活检和血清生化检测。进行了骨组织学、铝的组织化学染色以及骨铝含量测定。在50%的透析患者和5%的未透析患者中发现了可染色的骨铝。透析患者中可染色骨铝的发现与高发病率和高死亡率相关；不仅在大多数低转换型骨软化症患者中可见，在47%的混合性尿毒症骨营养不良患者以及1例以甲状旁腺功能亢进为主的骨病患者中也可见。有可染色铝的患者骨量较低，成骨细胞和破骨细胞活性降低。含铝磷结合剂的累积剂量是一个主要危险因素。饮用水中的铝是另一个危险因素。血清生化检测和单次注射去铁胺均不能用作诊断工具。骨活检是唯一的诊断方法。
