Sucralfate, Intestinal Aluminum Absorption, and Aluminum Toxicity in a Patient on Dialysis
Authors: John A. Robertson
Journal: Annals of Internal Medicine (1989)

Brief Reports15 July 1989Sucralfate, Intestinal Aluminum Absorption, and Aluminum Toxicity in a Patient on DialysisJohn A. Robertson, MD, Isidro B. Salusky, MD, William G. Goodman, MD, Keith C. Norris, MD, Jack W. Coburn, MDJohn A. Robertson, MD, Isidro B. Salusky, MD, William G. Goodman, MD, Keith C. Norris, MD, Jack W. Coburn, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-111-2-179 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAluminum absorption from aluminum-containing phosphate-binding antacids is a major source of aluminum loading in patients on dialysis (1). The aluminum is retained when renal function is impaired, and it has been implicated in the pathogenesis of osteomalacia and encephalopathy in these patients (2). Sucralfate, the basic aluminum salt of sucrose sulfate, contains 21% aluminum by weight (3); it is widely used to treat peptic ulcer disease and gastritis (4). Sucralfate does not alter plasma aluminum levels in normal subjects (5). Aluminum can dissociate, however, from sucralfate at a low pH (6) and become bioavailable. Our case report and study data...References1. NorrisCrooksNebeker KPH. Clinical and laboratory features of aluminum-related bone disease: differences between sporadic and "epidemic" forms of the syndrome. Am J Kidney Dis. 1985;6:342-7. CrossrefMedlineGoogle Scholar2. Alfrey A. Aluminum metabolism. Kidney Int. 1986;29:S8-S11. Google Scholar3. Lione A. Aluminum toxicology and the aluminum-containing medications. Pharmacol Ther. 1985;29:255-85. CrossrefMedlineGoogle Scholar4. ShermanHwangWalkerEisinger REJR. Reduction in serum phosphorus due to sucralfate. Am J Gastroenterol. 1983;78:210-1. MedlineGoogle Scholar5. KinoshitaKumakiNakano HKH. Plasma aluminum levels of patients on long term sucralfate therapy. Res Comm Chem Pathol Pharmacol. 1982;35:515-8. MedlineGoogle Scholar6. NakazawaNagashimaSamloff SRI. Selective binding of sucralfate to gastric ulcer in man. Dig Dis Sci. 1981;26:297-300. CrossrefMedlineGoogle Scholar7. MillinerNebekerOtt DHS. Use of the deferoxamine infusion test in the diagnosis of aluminum-related osteodystrophy. Ann Intern Med. 1984;101:775-9. LinkGoogle Scholar8. KaehnyHeggAlfrey WAA. Gastrointestinal absorption of aluminum from aluminum-containing antacids. N Engl J Med. 1977;296:1389-90. CrossrefMedlineGoogle Scholar9. LeGendreAlfrey GA. Measuring picogram amounts of aluminum in biological tissue by flameless atomic absorption analysis of a chelate. Clin Chem. 1976;22:53-6. CrossrefMedlineGoogle Scholar10. LeungHendersonHalloDobbie AIDJ. Aluminum hydroxide versus sucralfate as a phosphate binder in uremia. Br Med J [Clin Res]. 1983;286:1379-81. CrossrefMedlineGoogle Scholar11. Burnatowska-HledinMayor MG. The effects of sucralfate ingestion on serum and specific tissue aluminum concentration in normal rats. J Toxicol Clin Toxicol. 1984;22:87-93. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: John A. Robertson, MD; Isidro B. Salusky, MD; William G. Goodman, MD; Keith C. Norris, MD; Jack W. 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