UREMIA, DIALYSIS AND ALUMINUM

Few studies have dealt with assaying aluminium levels in different tis sues of uremic patients; so far a comparison has never been made betwe en its accumulation in the various tissues of uremic patients and cont rols. Aluminium levels were determined in the following biological sam ples: 1) 111 serum samples from hemodialysis patients and 55 serum sam ples from normal subjects; 2) 47 urine samples from the same dialysis patients and 45 from the controls; autopsy tissue specimens (blood bil e, brain, rib, cartilage, cranium, lung, spleen, kidney aorta, vena ca va, liver, muscle) from 12 deceased dialysis patients undergoing post- mortem diagnosis and 10 autopsy cases in which death was not associate d with uremia. In living subjects, both serum and urinary levels of al uminium are significantly higher in hemodialysis patients than in cont rols; a significant positive correlation was found between serum and u rinary levels of aluminium. In autopsy specimens, aluminium levels wer e higher in the dialysis group than controls for all tissues; the diff erences were statistically significant except in heart and urine. Tiss ue concentrations of aluminium in the two groups were then analysed se parately both in uremic patients and controls. The highest values foun d in dialysis cases were in the bile, followed by blood, urine and lun g; levels in the other tissues were considerably lower. In controls, t he distribution was somewhat different, due to much lower levels in th e liver and bile with respect to dialysis cases. Again we found surpri singly high levels in the lung. The results show that aluminium storag e in uremic patients occurs in all organs and tissues albeit to differ ent degrees.