PEDIATRICS Vol. 71 No. 1 January 1983, pp. 56-58
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Accumulation of Aluminum in a Nondialyzed Uremic Child Receiving Aluminum Hydroxide

W. R. Griswold MD1, V. Reznik MD1, S. A. Mendoza MD1, D. Trauner MD1, and A. C. Alfrey MD1

1 From the University of California Medical Center, and University Hospital, San Diego

A child with renal insufficiency was treated with the oral phosphate binder aluminum hydroxide from age 6 to 31 months. The prescribed dose of elemental aluminum varied from 31 to 108 mg/kg/d. Concurrently the patient developed vitamin D-resistant osteomalacia which failed to improve with parathyroidectomy. Encephalopathy with myoclonic seizures, loss of speech, and motor impairment also occurred. Serum and bone aluminum levels were elevated at 334 µg/L (normal 7 ± 3 µg/L) and 156 mg/kg (normal 3.3 ± 2.9 mg/kg), respectively. This case demonstrates that aluminum may accumulate in tissue of children receiving oral aluminum hydroxide. The accumulation of aluminum may have contributed to the vitamin D-resistant osteomalacia and the encephaiopathy in this patient. Children receiving aluminum-containing antacids as phosphate binders should be monitored for aluminum accumulation and signs of aluminum intoxication.

Key Words: aluminum toxicity • dialysis encephalopathy • aluminum osteodystrophy • dialysis dementia

Submitted on March 2, 1982




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