Bone aluminum accumulation in the current era
J Bras Nefrol. 2024 Apr 29;46(3):e20240023.
doi: 10.1590/2175-8239-JBN-2024-0023en.
eCollection 2024.
[Article in
English,
Portuguese]
Affiliations
- 1 Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Laboratório para o Estudo Mineral e Ósseo em Nefrologia (LEMON), Campinas, SP, Brazil.
- 2 Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Clínica Médica, Divisão de Nefrologia, Campinas, SP, Brazil.
- 3 Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Nefrologia, São Paulo, SP, Brazil.
- 4 Universidade de São Paulo, Faculdade de Medicina, Departamento de Clínica Médica, Laboratório de Fisiopatologia Renal (LIM-16), São Paulo, SP, Brazil.
Abstract
In the last few years, evidence from the Brazilian Registry of Bone Biopsy (REBRABO) has pointed out a high incidence of aluminum (Al) accumulation in the bones of patients with CKD under dialysis. This surprising finding does not appear to be merely a passive metal accumulation, as prospective data from REBRABO suggest that the presence of Al in bone may be independently associated with major adverse cardiovascular events. This information contrasts with the perception of epidemiologic control of this condition around the world. In this opinion paper, we discussed why the diagnosis of Al accumulation in bone is not reported in other parts of the world. We also discuss a range of possibilities to understand why bone Al accumulation still occurs, not as a classical syndrome with systemic signs of intoxication, as occurred it has in the past.
MeSH terms
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Aluminum* / adverse effects
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Aluminum* / metabolism
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Bone and Bones* / metabolism
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Brazil / epidemiology
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Humans
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Renal Dialysis
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Renal Insufficiency, Chronic / complications
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Renal Insufficiency, Chronic / metabolism