Concentration of serum aluminum in children on long-term parenteral nutrition

Contamination of parenteral nutrition solutions with aluminum may result in accumulation of this element in bones and may inhibit bone calcium uptake and induce cholestasis in premature infants. The possible association of al uminum not only with metabolic bone disease, but also with encephalopathy d ictates caution when dealing with the pediatric population on long-term par enteral nutrition. The aim of the study was to assess serum aluminum concen tration in 12 children aged from 7 months to 7 years on parenteral nutritio n from 6 months to 4 years and 4 months. Parenteral nutrition was required because of short bowel syndrome in 10 children, pseudoobstruction syndrome in 1 child, autoimmune enteropathy in 1 child. Aluminum intake from parente ral nutrition was 6.6 - 10.8 mu g/kg/day, a dose exceeding the safety limit of 2 mu g/kg/day (ASCN / ASPEN recommendations for the limitation of intra venous aluminum loading). The method used was graphite furnace atomic absor ption spectrometry GTA-AAS (Spectraa-400 Plus;Varian). Quality central was run with the use of control serum (Seronorm;Nycomed,Oslo). Normal serum lev els of aluminum are <20 mu g/l. Toxicity has been documented at 100 mu g/l, but serum aluminum levels do not reflect tissue loading. We found increase d aluminum levels in 10 children: in 7 children 20-30 mu g/l, in 2 children 30-40 mu g/l, in 1 child >50 mu g/l. It seems, therefore, justified to mon itor aluminum concentration in parenteral nutrition products and its intake in parenterally fed children.