Newborns
Infant formulas, especially soy-based formulas, contain aluminum (Al). Aluminum content in infant formula is higher than in human breast milk or in cow's milk. Specialized formulas for premature infants contain even higher aluminum content than standard formulas. For adults, typical dietary intake of Al is 40 to 50 mcg/kg of body weight/day. In comparison, infants on soy formula may consume as much as 250 mcg/kg/day of Al.
Premature Infants Receiving IV Therapy
Intravenous therapy contaminated with aluminum (Al) causes Al loading. Al is potentially neurotoxic and long-term IV feeding is associated with impaired neurologic development in premature infants.1
The Elderly
Researchers have determined that the elderly may be vulnerable to aluminum (Al) toxicity due to insufficient renal clearance.2 It has also been suggested that there is a possible Al association with dementia, ALS, and Alzheimer's disease.1,3,4 Supporting this assertion is research that shows that people with probable Alzheimer's disease have serum aluminum levels that are often significantly higher than either people with other types of dementia or healthy people of similar ages.5
Dialysis Patients and Others with Impaired Renal Function
Aluminum (Al) contaminates various fluids that are used in intravenous therapy, and its accumulation is associated with bone disease and encephalopathy.6 Accumulation of Al in the body tends to occur when the gastrointestinal barrier, which blocks absorption, is circumvented.1 Because the body primarily excretes these metals through the kidney, renal dysfunction can result in an increased risk of accumulating aluminum (Al). This population requires special attention in order to reduce the intake of Al.1
Patients Receiving Total Parenteral Nutrition (TPN)
Adults and children receiving parenteral nutrition may experience toxic effects of aluminum (Al).7,8 Parenteral therapy bypasses the body's protective mechanisms (gastrointestinal barrier, skin) potentially causing renal impairment and the intake of high levels of Al.
Burn Patients
Burn patients may be at risk of high aluminum (Al) intake because they receive large quantities of albumin and often have impaired renal function. Unless they are treated with low aluminum albumin, these factors combined place burn patients at higher risk for Al loading. In severely burned patients, accumulation of Al may play a role in the development of bone lesions.9
References
| 1. |
|
Monteagudo FS, Cassidy MJ, Folb PI. Recent developments in aluminum toxicology. Med Toxicol Adverse Drug Exp. 1989;4(1):1-16. |
| 2. |
|
Berend K, van der Voet G, Boer WH. Acute aluminum encephalopathy in a dialysis center caused by a cement mortar water distribution pipe. Kidney Int. 2001;59:746-753. |
| 3. |
|
Perl DP, Brody AR. Alzheimer's disease: x-ray spectrometric evidence of aluminum accumulation in neurofibrillary tangle-bearing neurons. Science. 1980;208:297-299. |
| 4. |
|
Perl DP, Gajdusek DC, Garruto RM, Yanagihara RT, Gibbs CJ. Intraneuronal aluminum accumulation in amyotrophic lateral sclerosis and Parkinsonism-dementia of Guam. Science. 1982;217:1053-1055. |
| 5. |
|
Zapatero MD, Garcia de Jalon A, Pascual F, Calvo ML, Escanero J, Marro A. Serum aluminum levels in Alzheimer's disease and other senile dementias. Biol Trace Elem Res. 1995;47(1-3):235-240. |
| 6. |
|
Klein GL, Herndon DN, Rutan TC, Miller NL, Alfrey AC. Elevated serum aluminum levels in severely burned patients who are receiving large quantities of albumin. J Burn Care Rehabil. 1990;11(6):526-530. |
| 7. |
|
Klein GL. Aluminum in parenteral products: medical perspective on large and small volume parenteral. J Parenter Sci Technol. 1989;43(3):120-124. |
| 8. |
|
Bishop NJ, Morley R, Day JP, Lucas A. Aluminum neurotoxicity in preterm infants receiving intravenous-feeding solutions. N Engl J Med. 1997;336(22):1557-1561. |
| 9. |
|
Klein GL, Herndon DN, Rutan TC, Barnett JR, Miller NL, Alfrey AC. Risk of aluminum accumulation in patients with burns and ways to reduce it. J Burn Care Rehabil. 1994;15(4):354-358. |
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