Bone disorders in children with chronic renal insufficiency exposed to high ingestion of aluminum
Gordillo-Paniagua, G.; Valencia-Mayoral, P.; Mercado, L.; Medina-Mercado, M.
Boletin Medico del Hospital Infantil de Mexico 47(5): 336-341
1990
ISSN/ISBN: 0539-6115 PMID: 2390188 Document Number: 353111
Bone disorders in 28 children with chronic renal failure exposed to aluminum intoxication were studied. All of the children were in the dialysis program. Aluminum blood levels were higher than normal in all of the children and without any correlation to the magnitude of hypocalcemia or with the increase of the parathormone, which were found in different amounts in all of the children. All of the children had various degrees of skeletal retardation and only one had pathological fractures. The bone biopsy showed hypocellular marrow, decreased osteoclastic activity in the majority of the cases same as trabecular mineralization, although the amount of osteoid was lacking in the trabeculae in the majority of the cases. The deposit of aluminum was detected in a great number of them. It is concluded that osteodystrophy recognizes a number of factors as may be hypocalcemia due to a decrease in the production of 1,25-cholecalciferol, an increase in the parathyroid hormone and the deposit of aluminum, coming mainly from water, in the trabeculae which interfere with the incorporation of calcium in the formation of new bone.