ABSTRACT
The chief mineral source of Jammu province is bauxite, an aluminium ore, so a possibility of water being heavily polluted with aluminium is prevalent. Hence, in an effort to relate this regional geographical aspect with aluminium bone disease (ABD) in chronic renal failure (CRF), 50 cases of CRF were prospectively evaluated. Patients were subjected to a thorough history and clinical examination. Biochemical parameters along with raiological skeletal survey and iliac crest bone biopsies were undertaken. Sixty-eight per cent of CRF patients were also consuming aluminium containing phosphate binders (ACPB) at that time. The study revealed an occurrence of ABD in 10% of CRF patients. It was found predominantly superimposed upon osteomalacia (8%) and mixed osteodystrophy (2%). Superimposed ABD on osteomalacia was found more frequently in pre-dialysis (10.8%) than after haemodialysis group (7.69%). Moreover, the incidence of ABD superimposed on osteomalacia and mixed osteodystrophy was higher in the ACPB group (14.7%) than the post-haemodialysis group (7.69%). Correlating, the pre-dialysis, post-haemodialysis and ACPB ingestion status of CRF patients on one hand and histologically proven ABD on the other, it was deduced that the majority of cases of CRF having ABD was seen in ACPB ingestion group (14.7%) followed by pre-dialysis (10.8%) and post-haemodialysis (7.69%) groups. Thus it was concluded that in the present work, ACPB ingestion was the major source of aluminium deposition in bones of patients with CRF rather than the water used in dialysis or possible pollution of drinking water with aluminium in our province.