Premium
Excessive Aluminum Accumulation in the Bones of Patients on Long‐Term Parenteral Nutrition
Author(s) -
Kruger Pamela C.,
Parsons Patrick J.,
Galusha Aubrey L.,
Morrissette Michelle,
Recker Robert R.,
Howard Lyn J.
Publication year - 2014
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607113491981
Subject(s) - parenteral nutrition , medicine , toxicity , autopsy , surgery , gastroenterology
Background : Aluminum (Al) contamination of parenteral nutrition (PN) solutions remains a concern for long‐term PN patients. Al accumulates particularly in bone. Excessive exposure to Al may result in increased Al body burden and impaired bone formation and mineralization, leading to bone disease. Although the U.S. Food and Drug Administration (FDA) has limited Al contamination in large‐volume parenteral solutions, small‐volume parenterals may still contribute considerable amounts of Al to PN solutions. The goal of this study is to determine whether or not long‐term adult PN patients remain at risk for increased bone Al accumulation. Methods : We measured Al accumulation in autopsy bones from 7 patients who had received PN for 2–21 years and compared bone Al levels with those in living control patients undergoing hip or knee replacement. Electrothermal atomic absorption spectrometry was used for bone Al measurements. Results : When compared with bone Al content in controls, markedly elevated Al levels ( P < .0001) were found in the bones of all but 1 patient, who received PN for only 2 years before death. Even greater Al accumulation was found for PN patients who developed late renal impairment ( P = .0159). Conclusions : We conclude that long‐term adult PN patients continue to be at risk for Al toxicity.