Smith P S, McClure J
J Clin Pathol. 1982 Nov;35(11):1283-93. doi: 10.1136/jcp.35.11.1283.
Histochemical studies and electron probe x-ray microanalysis for aluminium have been performed on 16 samples of undecalcified bone from cases of renal osteodystrophy associated with a syndrome suggestive of dialysis encephalopathy (five cases), age and sex matched controls for these and a group of patients with chronic renal failure (six cases) who have never been on haemodialysis. Aluminium was detected only in the patients with a dialysis encephalopathy-like syndrome. This group had significant histological bone disease the features of which were broadly consistent with the so-called atypical renal osteomalacia which is thought to be due to a metal toxin. Aluminium was demonstrated at the interface between osteoid and mineralised tissue--that is, at the site of the calcification front, where it could interfere with the mineralisation process. In the group of patients who had never been subjected to haemodialysis there was also significant histological bone disease but no evidence of aluminium accumulation. In this group the bone disease was of a more typical pattern of osteomalacic changes coupled with those of hyperparathyroidism.
已对16份来自肾性骨营养不良病例的未脱钙骨样本进行了铝的组织化学研究和电子探针X射线微量分析，这些病例伴有提示透析性脑病的综合征（5例），以及与之年龄和性别匹配的对照组，还有一组从未接受过血液透析的慢性肾衰竭患者（6例）。仅在患有类似透析性脑病综合征的患者中检测到铝。该组存在明显的组织学骨病，其特征与所谓的非典型肾性骨软化症大致相符，后者被认为是由金属毒素引起的。在类骨质与矿化组织的界面处——即钙化前沿的部位，证实有铝存在，铝可能在该部位干扰矿化过程。在从未接受过血液透析的患者组中，也存在明显的组织学骨病，但没有铝蓄积的证据。在该组中，骨病呈现出更典型的骨软化改变模式，并伴有甲状旁腺功能亢进的改变。
