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Aluminum toxicity in chronic kidney disease

Wajeh Y Qunibi, MD
William L Henrich, MD, MACP
Section Editor
Jeffrey S Berns, MD
Deputy Editor
Alice M Sheridan, MD


Aluminum toxicity is a systemic disorder observed in hemodialysis patients and occasionally in nondialysis patients who have severe chronic kidney disease (CKD; ie, glomerular filtration rate [GFR] <30 mL/min/1.73 m2). Aluminum toxicity primarily results from exposure to aluminum in dialysis fluid and from the ingestion of aluminum-containing phosphate binders among patients who cannot excrete it [1].

Aluminum toxicity is now uncommon because aluminum is now removed from water used for dialysis and because nonaluminum-containing phosphate binders are widely available [2].

This topic reviews aluminum toxicity in CKD patients, particularly in hemodialysis patients, in whom it is still occasionally observed. Other forms of bone disease commonly observed among CKD patients are discussed elsewhere. (See "Overview of chronic kidney disease-mineral and bone disorder (CKD-MBD)".)

Techniques that are utilized for the removal of aluminum from dialysis water are discussed elsewhere. (See "Water purification systems in hemodialysis" and "Contaminants in water used for hemodialysis" and "Maintaining water quality for hemodialysis".)

Nonaluminum phosphate binders are discussed elsewhere. (See "Management of hyperphosphatemia in chronic kidney disease", section on 'Specific treatment'.)

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Literature review current through: Nov 2017. | This topic last updated: Jan 19, 2017.
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