BONE ALUMINUM STATUS IMPROVES AFTER KIDNEY-TRANSPLANTATION

Aluminium osteomalacia and aluminium-induced adynamic bone disease as a variant of low-turnover aluminium osteopathy are problems in end sta ge renal failure. Earlier human cell models showed that a successful k idney transplantation can result in decreased aluminium stores, which were raised before transplantation depending on the degree of renal in sufficiency. We studied bone aluminium concentrations in 10 haemodialy sis patients, who had received treatment for 3.6 +/- 1.5 yr and the sa me patients after kidney transplantation (serum creatinine: 1.0-1.3 mg dL(-1), after 45.4 +/- 30.3 months after TX). Bone aluminium content was determined by atomic absorption spectroscopy. Bone biopsies were t aken from iliac crest of each patient (five males/five females, age 44 .3 +/- 6.4 yr). An aluminon colouring was also performed in each bone sample. The mean intact parathyroid hormone (iPTH) levels were slightl y elevated (12.7 pmol L-1). Mean serum calcium levels of 2.4 mmol L-1 and alkaline phosphatase (AP) of 148 U L-1 respectively were in normal ranges. In two cases of positive aluminon colouring no aluminon could be shown after kidney transplantation. Bone aluminium content was 7.2 +/- 5.6 mu g g(-1) wet weight after kidney transplantation as compare d to pre-transplantation values of 13.0 +/- 4.7 mu g g(-1) wet weight (p < 0.02), nearly reaching the normal range for bone aluminium conten t (< 6 mu g g(-1) wet weight). These findings indicate that aluminium bone disease may be improved by kidney transplantation.