Aluminium-induced, reversible microcytic anemia in chronic renal failure: clinical and experimental studies
Touam, M.; Martinez, F.; Lacour, B.; Bourdon, R.; Zingraff, J.; Di Giulio, S.; Drüeke, T.
Clinical Nephrology 19(6): 295-298
1983
ISSN/ISBN: 0301-0430 PMID: 6872366 Document Number: 209919
Ten chronic hemodialysis patients with severe Al intoxication developed a microcytic anemia despite oral Fe supplementation. Their microcytosis was reversible after deionization of the dialysis water. Ten age- and sex-matched hemodialysis patients who were not Al-intoxicated but who had a comparable treatment schedule and time on dialysis had no such microcytosis. In order to investigate a possible direct role of Al, uremic rats were intoxicated by daily (6/7 days a wk) i.p. injections of 30 nmol/day of Al. After 3 mo., the Al-intoxicated uremic rats had a significantly lower hematocrit (34.7%), Hb (12.0 g/dl) and MCV (52.5 fl) than the control, vehicle-injected uremic animals (37.4%, 13.1 g/dl and 60.4 fl, respectively). The reticulocyte counts of the intoxicated rats were increased. Serum Fe and transferrin iron binding capacity were unchanged. Al intoxication of the uremic organism leads to a microcytic anemia possibly by interfering directly with normal Hb synthesis.