A clinical study on the change of aluminium in a blood of the chronic renal failure patients undergoing hemodialysis / 대한내과학회지

ABSTRACT

BACKGROUND: More than 25 years have been passed since Korea started the hemodialysis. Initially, the technical problems of dialysis machine, a handling of azotemia, sustained anemia, as well as renal osteodystrophy were major matters we have to solve, however, recently the focused matters were changed that the removal of heavier molecular weighed uremic toxins, toxins like aluminium and silicon are very important, because these toxins are hardly removed and are very influential on the uremic signs. In this study, we planned to observe how much aluminium accumulated in chronic hemodialysis patients, and how much significant is increased aluminium blood level in patients. METHODS: We randomly selected fifty patients undergoing chronic hemodialysis to estimate the serum level of aluminium. We analyzed patients by using clinical informations, such as the time period of hemodialysis, the dialysis frequency, whether diabetes or not , according to the aluminium serum levels. The aluminium serum levels were estimated before and after the hemodialysis, which were measured by using the atomic absorption spectrophotometry. RESULTS: The serum levels of aluminium in CRF patients undergoing hemodialysis were significantly increased, as compared with normal range and much more increased levels was observed after hemodialysis 48.9+/-3.2 microgram/L than before 27.6+/-2.3 microgram/L (p<0.05) (Table 2). The aluminium level before hemodialysis of diabetic patients (40.3+/-17.6 microgram/L) showed I.57 times higher than non-diabetes (25.7+/-21.2 microgram/L), but the level after hemodialysis showed non-significant difference (Figure 1). The aluminium blood level after hemodialysis and the duration of hemodialysis were correlated positively (r=0.34, p<0.01), but this wasn't before hemodialysis (Figure 2). The serum level of aluminium tends upward following to increasing level of serum calcium, serum magnesium, as well as parathyroid hormone (Table 3). The delta aluminium(post-pre dialysis) level was significantly correlated positively (r=0.66, p<0.05) with delta Hb (post-pre dialysis) level (Figure 3). CONCLUSION: The serum level of aluminium in chronic renal failure patients undergoing hemodialysis were significantly increased and especially, more increased as soon as the hemodialysis was finished.