The use of parenteral nutrition fluids that are high in aluminum should be eliminated or significantly reduced. Collectively, the studies reviewed give some support to the hypothesis that Al exposure leads to neuropsychological deficits, but confounding exposure have not been ruled out. It is recommended, therefore, that there is a need for more detailed studies of absorption,metabolism and neurotoxic effects of aluminum in occupational settings. It would be useful to monitor the total aluminum content in serum and urine of exposed workers. Furthermore, there should be detailed neuropathological studies at autopsy of workers highly exposed to aluminum, and close comparison with similar studies in long-term dialysis patients in the general population.
Preterm infants are particularly vulnerable to aluminum because of their immature renal function.
Citrate should be never prescribed at the same time as Al-containing phosphate binders. Patients on home total parenteral nutrition should be regularly checked for serum and urine aluminum concentrations, and intravenous solutions should be monitored for Al levels. In addition, to analytical procedures, contamination derived from equipment may be evident during dialysis treatment. Besides total Al content in biological samples its distribution between high weight mass and low weight mass binders should be determined and considered. P. Zatta , CNR Center on Metalloproteins.