Chronic renal failure often complicated hypertension, anemia, heart failure,
pericarditis, cardiomyopathy, hydropower disorders and acid-base balance, renal
osteodystrophy, fractures, and infection. In addition to the above
complications, the long-term dialysis chronic renal failure may also be
complicated by aluminum toxicity, conventional dialysis patients with end-stage
renal disease complicated by aluminum toxicity. Many causes of chronic renal
failure in hemodialysis patients with regular aluminum poisoning, including:
excessive dialysate aluminum content. When the dialysate aluminum content close
to 50μg / L, a high incidence of aluminum-related bone disease. Therefore, the
authors recommend dialysate aluminum content of at least should be less than
10μg / L, preferably less than 5μg / L. The kidney is the only way to rows of
aluminum, chronic renal failure, when absorbed aluminum accumulate in the body
may cause aluminum poisoning. End-stage renal disease patients aluminum
excretion blocked, more heavy aluminum accumulation in the body, the content of
aluminum in the body may be 20 times higher than normal. Aluminum accumulation
largest organ is the bone, liver, and spleen. The increase in the aluminum
content of bone and aluminum poisoning can lead to aluminum-related bone
disease. Aluminum deposited mainly in calcified bone edge, namely the young
mineralized bone and non-mineralized bone interface, cause osteomalacia.
Osteomalacia histological changes in the degree of severity of the aluminum
deposition calcified bone edges related. And aplastic bone disease osteomalacia
may be a prelude to aluminum caused. Aplastic bone disease was first reported in
1982, a renal osteodystrophy. Now that this is peritoneal dialysis patients with
chronic renal failure, a major bone lesions. Some cases are caused by the
excessive accumulation of aluminum, but too much parathyroid hormone suppression
may be a more important reason. PTH has an important role in the maintenance of
normal bone metabolism. Parathyroid hormones may increase bone transport by
preventing deposition of aluminum at the leading edge of mineralization, and
parathyroidectomy aluminum-related bone disease is a risk factor for the
occurrence, it can reduce bone formation rate and turnover rate , the aluminum
accumulation in bone calcification edge, thereby interfering with the process of
bone mineralization. Clinically, in patients with secondary hyperparathyroidism
parathyroidectomy consider doing before aluminum-related bone disease should be
excluded because the deposition of aluminum to reduce parathyroid hormone levels
in patients with osteomalacia can accelerate coexist in the bone and accelerates
the aluminum-related bone disease occurs. Aluminum-related bone disease in the
past reported the incidence was as high as 15% to 25%. In recent years, due to
the restrictions on the use of aluminum-containing noticed phosphate binders and
improved treatment of dialysate, the incidence rate has decreased
significantly.
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