[Kinetics of plasma and urine aluminium after renal grafting (author's transl)].

Kinetics of plasma and urine aluminium (Al) were studied prospectively in 40 kidney recipients during 6 months following grafting, including 2 patients with dialysis encephalopathy. Two groups of patients were defined according to graft function outcome. Group I: successful grafting, either immediate (Ia), or delayed (Ib); group II: immediate and definitive graft failure. A control group was added including hemodialysis patients undergoing non-transplantation surgery (without steroid therapy). Recipients of group I excreted high amounts of A1 and progressively normalized their plasma A1 within 6 months (13 Micron g/1 +/- 7 versus less than 10 Micron g/1 in normal subjects). The average A1 excretion during the first month was 9539 Micron g +/- 12.233 Micron in group Ia and 9048 Micron g +/- 4445 Micron g in group Ib. In one encephalopathic patient (group Ia), it even reached 2166 Micron g per day and amounted to 44.727 Micron g during the first month. In all groups taken as a whole, an early period of increase in plasma A1 occurred which was moderate and observed mostly in patients with low initial plasma A1 values (less than 50 Micron g/1) in group Ia, but high and significant (p less than 0.01) in group Ib. This increase was present as well in group II (p less than 0.01) but to a somewhat lesser extent than in group Ib. The mechanism of this sharp increase of plasma A1 in the early period following grafting is not clear. Two major factors are discussed : steroid therapy or A1 (OH)3 ingestion, but there was no correlation between given doses and plasma A1 levels after grafting; persistent hyperparathyroidism which could enhance A1 intestinal absorption.