Microcytic Anemia in Dialysis Patients: Reversible Marker of Aluminum Toxicity

1987 ◽  
Vol 9 (3) ◽  
pp. 217-223 ◽  
Author(s):  
Richard Swartz ◽  
Janet Dombrouski ◽  
Maria Burnatowska-Hledin ◽  
Gilbert Mayor
Keyword(s):  
Aluminum Toxicity ◽  
Microcytic Anemia ◽  
Dialysis Patients

Aluminum Toxicity in Dialysis Patients

2015 ◽  
pp. 198-220 ◽  
Author(s):  
F. L. Van de Vyver ◽  
F. J. E. Silva ◽  
P. C. D�Haese ◽  
A. H. Verbueken ◽  
M. E. De Broe
Keyword(s):  
Aluminum Toxicity ◽  
Dialysis Patients

scholarly journals Prevalence and management of anemia in pre-dialysis Malaysian patients: A hospital-based study

2016 ◽  
Vol 62 (8) ◽  
pp. 742-747 ◽  
Author(s):  
Muhammad Salman ◽  
Amer Hayat Khan ◽  
Azreen Syazril Adnan ◽  
Syed Azhar Syed Sulaiman ◽  
Khalid Hussain ◽  
...  
Keyword(s):  
Renal Function ◽  
Positive Impact ◽  
Kidney Diseases ◽  
Macrocytic Anemia ◽  
Intravenous Iron ◽  
Microcytic Anemia ◽  
Normocytic Anemia ◽  
Dialysis Patients ◽  
Stabilizing Agents ◽  
Prevalence Of Anemia

Summary Objective: Anemia, a common complication of chronic kidney diseases (CKD), is involved in significant cardiovascular morbidity. Therefore, the objective of our study was to investigate the prevalence and severity of anemia in pre-dialysis patients, as well as to determine the predictors of anti-anemic therapy. Method: A retrospective, observational study was conducted on adult pre-dialysis patients receiving treatment at the Hospital Universiti Sains Malaysia from January 2009 to December 2013. Results: A total of 615 eligible cases were included. The mean age of patients was 64.1±12.0 years. The prevalence of anemia was 75.8%, and the severity of anemia was mild in 47.7% of the patients, moderate in 32.2%, and severe in 20%. Based on morphological classification of anemia, 76.9% of our patients had normochromic-normocytic anemia whereas 21.8 and 1.3% had hypochromic-microcytic anemia and macrocytic anemia, respectively. Oral iron supplements were prescribed to 38.0% of the patients and none of the patients was given erythropoietin stabilizing agents (ESA) or intravenous iron preparations. In logistic regression, significant predictors of anti-anemic preparation use were decreased hemoglobin and hematocrit, and advanced stages of CKD. Conclusion: The results of the present study suggest that the prevalence of anemia in pre-dialysis patients is higher than currently accepted and it is found to be correlated with renal function; prevalence increases with declined renal function. An earlier identification as well as appropriate management of anemia will not only have a positive impact on quality of life but also reduce hospitalizations of CKD patients due to cardiovascular events.

Aluminum as a toxicant

2002 ◽  
Vol 18 (7) ◽  
pp. 309-320 ◽  
Author(s):  
A Becaria ◽  
A Campbell ◽  
SC Bondy
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Neurodegenerative Disorders ◽  
Tissue Damage ◽  
Biological Function ◽  
Aluminum Toxicity ◽  
Microcytic Anemia ◽  
Causal Role ◽  
Dialysis Encephalopathy ◽  
Age Related

Although aluminum is the most abundant metal in nature, it has no known biological function. However, it is known that there is a causal role for aluminum in dialysis encephalopathy, microcytic anemia, and osteomalacia. Aluminum has also been proposed to play a role in the pathogenesis of Alzheimer’s disease (AD) even though this issue is controversial. The exact mechanism of aluminum toxicity is not known but accumulating evidence suggests that the metal can potentiate oxidative and inflammatory events, eventually leading to tissue damage. This review encompasses the general toxicology of aluminum with emphasis on the potential mechanisms by which it may accelerate the progression of chronic age-related neurodegenerative disorders.

scholarly journals Aluminum Toxicity: Evaluation of 16-Year Trend Among 14 919 Patients and 45 480 Results

2018 ◽  
Vol 142 (6) ◽  
pp. 742-746 ◽  
Author(s):  
Ron B. Schifman ◽  
Daniel R. Luevano
Keyword(s):  
Chronic Toxicity ◽  
Aluminum Toxicity ◽  
Serum Levels ◽  
Veterans Affairs ◽  
Repeated Measurements ◽  
Dialysis Fluid ◽  
Dialysis Patients ◽  
Toxicity Evaluation ◽  
Long Term Trends

Context.— Annual monitoring with serum aluminum measurements is recommended for dialysis patients who are susceptible to toxic accumulation from contaminated dialysis fluid or from ingestion of aluminum-containing medications. Objective.— To evaluate long-term trends in serum aluminum concentrations and frequency of chronic toxicity. Design.— A retrospective observational study was conducted by analyzing serum aluminum results obtained from the Veterans Affairs corporate data warehouse. Serum aluminum concentrations of 60 μg/L or greater were considered false positives and not indicative of chronic toxicity if another specimen retested within 45 days had a concentration below 20 μg/L. Results.— A total of 45 480 serum aluminum results involving 14 919 patients and 119 Veteran Affairs facilities during a 16-year period ending in October 2016 were evaluated. The percentage of elevated (≥20 μg/L) serum aluminum results declined from 31.5% in 2000 to 2.0% in 2015. Average testing intervals changed from every 159 days in 2000 to every 238 days in 2015. Of 529 patients with serum aluminum concentrations of 60 μg/L or greater, 216 (40.8%) were retested within 45 days (average = 21 days); of these, 83 (38.4%) had concentrations below 20 μg/L after repeated measurements. Retesting rates increased with higher initial serum aluminum concentrations. Conclusions.— Aluminum toxicity, as assessed by serum levels, has substantially declined over time and is now rare. Many serum aluminum concentrations in the toxic range were not confirmed after retesting. Patients with toxic serum aluminum concentrations should be retested with another specimen before undergoing treatment or investigating sources of exposure to verify abnormal results.

Relationship between intact 1–84 parathyroid hormone and bone histomorphometric parameters in dialysis patients without aluminum toxicity

1995 ◽  
Vol 26 (5) ◽  
pp. 836-844 ◽  
Author(s):  
Mei Wang ◽  
Gavril Hercz ◽  
Donald J. Sherrard ◽  
Norma A. Maloney ◽  
Gino V. Segre ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Aluminum Toxicity ◽  
Dialysis Patients

Serum Thiamine Values in End-Stage Renal Disease Patients under Maintenance Hemodialysis

2015 ◽  
Vol 85 (5-6) ◽  
pp. 348-355 ◽  
Author(s):  
Masamitsu Ubukata ◽  
Nobuyuki Amemiya ◽  
Kosaku Nitta ◽  
Takashi Takei
Keyword(s):  
Thiamine Deficiency ◽  
Risk Index ◽  
Nutritional Risk ◽  
Maintenance Hemodialysis ◽  
Dialysis Patients ◽  
Significant Difference ◽  
Nutritional Risk Index ◽  
Serum Aspartate Aminotransferase ◽  
Stage Renal Disease ◽  
End Stage

Abstract. Objective: Hemodialysis patients are prone to malnutrition because of diet or many uremic complications. The objective of this study is to determine whether thiamine deficiency is associated with regular dialysis patients. Methods: To determine whether thiamine deficiency is associated with regular dialysis patients, we measured thiamine in 100 patients undergoing consecutive dialysis. Results: Average thiamine levels were not low in both pre-hemodialysis (50.1 ± 75.9 ng/mL; normal range 24 - 66 ng/mL) and post-hemodialysis (56.4 ± 61.7 ng/mL). In 18 patients, post-hemodialysis levels of thiamine were lower than pre-hemodialysis levels. We divided the patients into two groups, the decrease (Δthiamine/pre thiamine < 0; - 0.13 ± 0.11) group (n = 18) and the increase (Δthiamine/pre thiamine> 0; 0.32 ± 0.21)) group (n = 82). However, there was no significance between the two groups in Kt/V or type of dialyzer. Patients were dichotomized according to median serum thiamine level in pre-hemodialysis into a high-thiamine group (≥ 35.5 ng/mL) and a low-thiamine group (< 35.4 ng/mL), and clinical characteristics were compared between the two groups. The low-thiamine value group (< 35.4 ng/ml; 26.8 ± 5.3 ng/ml) exhibited lower levels of serum aspartate aminotransferase and alanine aminotransferase than the high-thiamine value group (≥ 35.4 ng/ml; 73.5 ± 102.5 ng/ml) although there was no significance in nutritional marker, Alb, geriatric nutritional risk index , protein catabolic rate and creatinine generation rate. Conclusion: In our regular dialysis patients, excluding a few patients, we did not recognize thiamine deficiency and no significant difference in thiamine value between pre and post hemodialysis.

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