D'Haese P C, Couttenye M M, De Broe M E
Department of Nephrology/Hypertension, University of Antwerp, Belgium.
Nephrol Dial Transplant. 1996;11 Suppl 3:74-9. doi: 10.1093/ndt/11.supp3.74.
Aluminium accumulation in serum and tissues is a well-known complication in patients with chronic renal failure, and retention of the element in bone has been implicated in the pathogenesis of the so-called aluminium-related bone disease (ARBD). Regular serum aluminium monitoring remains mandatory to detect patients and centres at risk for aluminium intoxication. Early recognition of ARBD however requires a desferrioxamine (DFO) test in combination with a serum iPTH measurement. Definite diagnosis of ARBD is made by histological examination of a bone biopsy. Once ARBD has been identified DFO treatment should be initiated and all potential sources of aluminium exposure eliminated. In order to minimize the risk for DFO-related cerebral, auditory and visual side-effects, and siderophore-mediated opportunistic infections the chelator should be used at low doses (5 mg/kg) and administered widely spaced (once weekly) following well-defined strategies of administration.
血清和组织中铝的蓄积是慢性肾衰竭患者众所周知的并发症，该元素在骨骼中的潴留被认为与所谓的铝相关性骨病（ARBD）的发病机制有关。定期监测血清铝对于发现有铝中毒风险的患者和中心仍然至关重要。然而，ARBD的早期识别需要进行去铁胺（DFO）试验并结合血清iPTH测量。ARBD的明确诊断通过骨活检的组织学检查来确定。一旦确诊ARBD，应开始DFO治疗并消除所有潜在的铝暴露源。为了将DFO相关的脑、听觉和视觉副作用以及铁载体介导的机会性感染的风险降至最低，螯合剂应采用低剂量（5mg/kg），并按照明确的给药策略广泛间隔（每周一次）给药。
