[Initial evaluation of aluminum concentrations in patients with nephropathy and undergoing hemodialysis at the Miguel Pérez Carreño Hospital and the University Hospital of Caracas (Venezuela)]. / Evaluación inicial de las concentraciones de aluminio en pacientes con nefropatía y sometidos a hemodiálisis en los Hospitales Miguel Pérez Carreño y Universitario de Caracas (Venezuela).

The present work reports the concentrations of aluminum in whole blood and dialysis solutions of 27 patients with chronic renal failure and under hemodialysis treatment at Miguel Pérez Carreño and University Hospitals, both from Caracas city. Aluminum levels of the water used to prepare the dialysates were also monitored and the metal mobilization during dialysis studied. Patients' mean blood aluminum concentrations (ca. 34 micrograms AI/L) were lower than those of renal individuals from Maracaibo (ca. 58 micrograms AI/L), situation related to the low metal contents of the dialysate water (ca. 14 micrograms AI/L). In addition, Caracas drinking water showed up very high aluminum concentrations, above 475 micrograms/L. There was a relationship between the renal patients' blood aluminum concentrations and (1) the metal contents of the dialysis solutions and (2) the ingestion of aluminum hydroxide-based antacids. Aluminum transfer incorporation processes toward the patients' blood were observed in both dialysis units. This was due to the favorable concentration gradients (blood aluminum concentration/dialysate aluminum concentration) established at the start of every hemodialysis treatment.

Aluminum determination in whole blood, dialysis solution, and tap water samples from Maracaibo dialysis units (Venezuela) by graphite furnace atomic absorption spectrometry.

Patients with chronic renal failure (CRF) on periodical hemodialysis may accumulate aluminum in tissues and show typical disorders such as dialysis encephalopathy, osteodystrophy, and microcytic anemia. Aluminum contamination of the water used to prepare the dialysis solution (dialysate) is one of the metal sources that may affect people under hemodialysis, especially in units in which untreated water is used. Graphite furnace atomic absorption spectrometric methods for aluminum determination in whole blood, dialysis solution, and tap water samples from CRF patients were developed, based upon the use of the same furnace temperature program. Samples were diluted 4-fold with 0.6% triton X-100 (whole blood) or with 0.01 mol/L nitric acid (dialysis solution and tap water) and analyzed by aqueous standard (blood and tap water) or matrix-matching standard (dialysis solution) calibration curves. The characteristic masses were 33.8, 11.3, and 19.5 pg Al/0.0044 A.s for whole blood, dialysate, and tap water, respectively. In the diluted solutions, the detection limits (2 sigma) for the described methods were 0.5 microgram/L Al (whole blood), 0.4 microgram/L Al (dialysate), and 0.4 microgram/L Al (tap water). The methods were applied to samples from several CRF patients under hemodialysis at Maracaibo University hospital. The data revealed extremely high aluminum levels, which corresponded to the symptoms of dialysis encephalopathy and/or osteodystrophy showed by some of them. The proposed methods are reliable and reproducible.