参考

1. Water content of aluminum, dialysis dementia, and osteomalacia.

Wills MR, Savory J.
Environmental health perspectives.Environ Health Perspect.1985 Nov;63:141-7.
In the presence of normal renal function, a high concentration of aluminum in drinking water has been implicated as a factor in the etiology of a neurological syndrome in one specific geographical area. The role of aluminum as a toxic agent in other neurological disorders, where renal function is normal, is controversial. Aluminum is absorbed from the gastrointestinal tract and is normally excreted by the kidneys in the urine. In patients with chronic renal failure, aluminum appears to be of proven toxicological importance. In these patients the accumulation of aluminum in tissues causes an encephalopathy (dialysis encephalopathy or dialysis dementia), a specific form of metabolic bone disease (osteomalacic dialysis osteodystrophy), and an anemia and also plays an etiological role in some of the other complications associated with end-stage chronic renal disease. A failure in the normal renal excretory mechanism accounts for the tissue accumulation in chronic renal failure. The majority of chronic renal failure patients who develop aluminum toxicity are on long-term treatment with either hemo- or peritoneal dialysis; some patients develop toxicity who are only on treatment with aluminum-containing phosphate-binding agents. Aluminum in the dialysate appears to be the major source of the metal in chronic renal failure patients who develop aluminum toxicity. The aluminum content of the dialysate depends primarily on the content of the water with which it is prepared; there may be some contribution from the chemicals used in the concentrate which is added to the water. Some domestic tap-water supplies contain aluminum in high concentration, either naturally or because aluminum has been added as a flocculant in the purification process.(ABSTRACT TRUNCATED AT 250 WORDS)
PMID 3908086

Japanese Journal

続発性上皮小体機能亢進症に伴う骨病変に対する上皮小体摘除術の検討

石川泰章,紺屋英児,山手貴詔,尼崎直化,梅川徹,片山孔一,高村知諭,高田昌彦,梶川博司,加藤良成,片岡喜代徳,井口正典,栗田学,郡健二郎
日本泌尿器科學會雜誌 87(1), 67-73, 1996-01-20
… 術を施行している.(結果)骨関節痛の改善率は71例中49例,69%であった.改善群と非改善群の比較では年齢,術前の透析期間には有意差はなかったが,女性症例では改善率が低かった.(結論)C末端PTH高値の症例,高アルミニウム血症を認めない症例および線維性骨炎の存在する症例が上皮小体摘除術の適応であると考えられた.さらに,判断の困難な症例では全身骨シンチグラムと骨塩量測定(DPA法,DEXA法)が有用であり,両検査を施行し …
NAID 110003088803