Aluminum is associated with low bone formation in patients receiving chronic parenteral nutrition.

Patients treated with chronic total parenteral nutrition may develop metabolic bone disease. We evaluated 22 bone biopsy specimens from 16 patients. Compared with those of age- and sex-matched normal controls, these specimens had significantly higher osteoid area and lower total bone area and bone formation rate, as measured by double tetracycline labels. Aluminum was found in specimens from the 14 patients receiving casein hydrolysate but not in the two receiving amino acids as their nitrogen source. The reduced bone formation correlated inversely with the logarithm of the aluminum level. Aluminum was localized to the surface of mineralized bone; tetracycline uptake was absent at those sites. These bone findings are similar to those from aluminum intoxicated patients on hemodialysis. Both groups also have low parathyroid hormone levels. Thus, aluminum appears to be an important pathogenic factor in the osteodystrophy of patients receiving dialysis or total parenteral nutrition.

[1]  S. Ott,et al.  The prevalence of bone aluminum deposition in renal osteodystrophy and its relation to the response to calcitriol therapy. , 1982, The New England journal of medicine.

[2]  D. Sherrard,et al.  Aluminum loading during total parenteral nutrition. , 1982, The American journal of clinical nutrition.

[3]  S. Ott,et al.  Bone aluminum and histomorphometric features of renal osteodystrophy. , 1982, The Journal of clinical endocrinology and metabolism.

[4]  S. Ott,et al.  Histological quantitation of aluminum in iliac bone from patients with renal failure. , 1982, The Journal of laboratory and clinical medicine.

[5]  J. Harrison,et al.  A possible role of vitamin D in the genesis of parenteral-nutrition-induced metabolic bone disease. , 1981, Annals of internal medicine.

[6]  A. Norman,et al.  Reduced Serum Levels of Iα, 25-Dihydroxyvitamin D During Long-term Total Parenteral Nutrition , 1981 .

[7]  A. Norman,et al.  BONE DISEASE ASSOCIATED WITH TOTAL PARENTERAL NUTRITION , 1980, The Lancet.

[8]  J. Harrison,et al.  Metabolic bone disease in patients receiving long-term total parenteral nutrition. , 1980, Annals of internal medicine.

[9]  C. Cann,et al.  Aluminum uptake by the parathyroid glands. , 1979, The Journal of clinical endocrinology and metabolism.

[10]  H. A. Ellis,et al.  Bone aluminium in haemodialysed patients and in rats injected with aluminium chloride: relationship to impaired bone mineralisation. , 1979, Journal of clinical pathology.

[11]  T. Feest,et al.  FRACTURING DIALYSIS OSTEODYSTROPHY AND DIALYSIS ENCEPHALOPATHY An Epidemiological Survey , 1979, The Lancet.

[12]  J. Wergedal,et al.  Quantitative histological studies on the pathogenesis of uremic bone disease. , 1974, The Journal of clinical endocrinology and metabolism.

[13]  A. Alfrey,et al.  Measuring picogram amounts of aluminum in biological tissue by flameless atomic absorption analysis of a chelate. , 1976, Clinical chemistry.