Evaluation of serum aluminum level before and after (DFO) test in patients of hemodialysis unit of Zahedan

Aluminum accumulation in plasma and tissues is a well-described complication among persons undergoing peritoneal dialysis or hemodialysis. Excess bone aluminum is associated with low bone formation rates and increased risk for fractures. Current recommendations for care of patients with end-stage renal disease include screening for aluminum toxicity with plasma aluminum levels; patients with levels below20 micro g/L are considered to be at low risk for aluminum related bone disease (ARBD). By attention to some clinical symptoms that maybe related to AL toxicity, we measured serum AL level before and after DFO test. Methods and materials: In this descriptive study the incidence of AL toxicity in patients on hemodialysis in Khatam-Al-Anbia hospital of Zahedan-Iran was measured. In 35 patients on hemodialysis, serum level of AL before and after DFO test was measured. We also measured serum level of Ca, P, ALP, PTH and Ferritin in these groups of patients. To evaluate AL level in water used for hemodialysis it was measured at the same time. In our study serum AL levels in most of patients were high (32 out of 35). It maybe due to high level of AL in dialysate. Dialysate AL level before and after RO (Reverse Osmosis) were 16 microgram/Lit and 19.8 microgram/Lit respectively. In only 3 out of 35 patient’s serum AL levels of baseline were less than 20 microgram/Lit and DFO test in one of them was positive. Serums AL level of 16 patients were between 20 to 40 microgram / Lit and in 16 patients were more than 40 microgram/Lit. In conclusion treatment with improperly processed water was the major causes of aluminum toxicity in uremic patients.