Effect of oral potassium citrate on urinary excretion of aluminum after renal transplantation.
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:550A 1997
The effect of citrate administration on the urinary excretion of aluminum was evaluated in 15 patients following successful transplantation. All patients had serum creatinine less than 2.0 mg/dL, were between 1 and 43 days post transplantation and had a wide range of serum aluminum concentrations pre-transplantation. Following the ingestion of 6 g of potassium citrate, there was a doubling in the excretion of aluminum with the fractional excretion increasing from 0.92 to 2.15 %.
Comment: Although there has been a substantial decrease in the use of aluminum containing agents, a small minority of patients still develop aluminum toxicity. In general, successful renal transplantation results in a negative aluminum balance with eventual removal of tissue stores. It is unclear if there are a substantial number of patients who may require enhanced aluminum excretion following transplantation. Citrate is known to bind with aluminum and increases its gastrointestinal absorption. That it may enhance the renal excretion is not surprizing. Unfortunately serum aluminum concentrations do not reflect tissue stores, but represent recent aluminum exposure, thus it is unclear what effect citrate may have on tissue stores. Further studies would be required to determine whether citrate is effective in decreasing tissue stores and how many patients would benefit from such therapy. (Stuart Sprague, D.O., Northwestern University, Chicago, IL)
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ASN 30th Annual Meeting, San Antonio
Transplant : Transplantation
CRF by problem area : Bone disease/aluminum