possible role of aluminum toxicity in the pathogenesis of vascular abnormalities in patients with chronic renal failure under maintenance hemodialysis

ABSTRACT

This study was done on twenty-five patients with chronic renal failure on regular haemodialysis. The mean age was 44.1 +/- 8.5 years and the mean duration of dialysis was 2.8 +/- 2.2 years. The following findings are reported in. this study Gastro-duodenal angiodysplasia was found in 32% of the study group at the start of work and 62.5% of them were bleeding [melena hema-temesis]. Cases with angiodysplasia showed microcytic hypochromic anemia more than cases without, due to more risk of recurrent bleeding. Cases with angiodysplasia showed no significant difference in biochemical parameters including fasting blood sugar, blood urea, serum creatinine, serum calcium and serum phosphate. Cases with angiodysplasia showed higher serum aluminum levels and higher body stores of aluminum than cases without it. Prevalence of angiodysplasia is higher with higher serum aluminum level and with longer duration of dialysis. Decreasing serum aluminum level by administration of Dfo led to significant improvement of angiodysplasia as it was detected in 12% of the studied group at the end of the work. Half and half nail phenomena another vascular abnormality, was found in 48% of uremic patients studied [12 patients], and in 75% of uremic patients having angiodysplasia [6/8 patients]. Higher mean basal aluminum level was found in patients with half and half nail phenomena than cases without, denoting a probable role of aluminum as an etio-pathogentic factor for both vascular abnormalities