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      Effect of Calcium Supplement Preparation Containing Small Amounts of Citrate on the Absorption of Aluminium in Normal Subjects and in Renal Failure Patients

      , , ,

      Nephron

      S. Karger AG

      Calcium, Citrate, Aluminium, Chronic renal failure

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          Abstract

          It is well known that Al absorption is markedly enhanced by citrate. The aim of the study was to document whether low-dose citrate ingestion (4 g/day) contained in a well-known effervescent calcium supplement was sufficient to increase Al absorption in 16 normal volunteers and 15 subjects with stable chronic renal failure under conditions of either Ca carbonate or Al hydroxide supplementation. Serum and urine Al levels were measured using flameless atomic absorption spectrophotometry as previously described. After Ca carbonate plus Ca citrate ingestion, there was no rise over baseline (Ca Carbonate alone) serum or urine Al levels in either group. Ca carbonate and Al hydroxide taken together produced a significant rise in serum and urine Al levels in both groups. Maintaing Al hydroxide but substituting Ca citrate for the carbonate (same dose of elemental Ca) produced a further significant increment in serum Al (0.47 ± 0.28-1.15 ± 0.8 μmol/l; p < 0.001) and in urine Al(1.37 ± 0.46-5.77 ± 5.21 μmol/l; p < 0.001) in the chronic renal failure group as well as in serum Al (0.42 ± 0.2-0.76 ± 0.48 μmol/l; p < 0.001) and urine Al (2.70 ± 1.24-8.24 ± 3.96 μmol/l; p < 0.001 in the normal volunteer group. Due to decreased urine excretion, the increment in serum Al in the CRF group was significantly greater than in the normal subjects (p < 0.02). Thus small quantities of citrate present in effervescing Ca supplements can significantly enhance intestinal Al absorption even in normal subjects. All citrate-containing preparations are totally contra-indicated in chronic renal failure patients ingesting Al-containing compounds. Patients themselves should be warned of the dangers.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1994
          1994
          17 December 2008
          : 68
          : 2
          : 197-201
          Affiliations
          Division of Nephrology, Department of Medicine, University of the Witwatersrand, Johannesburg, South Africa
          Article
          188256 Nephron 1994;68:197–201
          10.1159/000188256
          7830856
          © 1994 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 5
          Categories
          Original Paper

          Cardiovascular Medicine, Nephrology

          Chronic renal failure, Aluminium, Citrate, Calcium

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