Clinical Investigation

Kidney International (1993) 43, 1313–1318; doi:10.1038/ki.1993.184

Effect of aluminum mobilization on hemoglobin during the first six months after transplantation

Andrew Davenport1, Kenneth E Newton1, Colin Toothill1, Eric J Will1 and Alexander M Davison1

1Department of Renal Medicine, St. James's University Hospital, and Trace Elements Laboratory, Chapel Allerton Hospital, Leeds, England, United Kingdom

Correspondence: Dr A Davenport, Department of Renal Medicine, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NP, England, United Kingdom.

Received 2 November 1992; Revised 18 January 1993; Accepted 18 January 1993.

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Abstract

Effect of aluminum mobilization on hemoglobin during the first six months after transplantation. We prospectively monitored 38 patients for the first six months following successful renal cadaver allograft transplantation. Hemoglobin increased from a mean of 8.2 plusminus 0.3 g/dl to 13.4 plusminus 0.3 g/dl (sem), P < 0.001, plasma aluminum decreased from 1.3 plusminus 0.2 micromol/liter to 0.46 plusminus 0.04 micromol/liter, P < 0.001, and urinary aluminum excretion which peaked at one week post-transplant, 5.5 plusminus 1.3 micromol/24 hr decreased to 1.8 plusminus 0.3 micromol/24 hr, P < 0.001. Prior to transplantation 22 patients had been prescribed aluminum-containing phosphate binders. Following transplantation this group had persistently greater plasma aluminum and urinary aluminum concentrations which were sustained throughout the study period, compared with those not given aluminum containing medicaments. Hemoglobin and iron status were similar in the two groups prior to transplantation, although red blood cell volume was smaller in those given aluminum-containing phosphate binders, 89 plusminus 0.9 fl (fentoliters) versus 95 plusminus 1.6 fl, P < 0.05. However, the percentage increase in hemoglobin following transplantation was greater in the group not given aluminum preparations, 34 plusminus 4% versus 7 plusminus 5% at one month, 69 plusminus 7% versus 37 plusminus 7% at three months, and 80 plusminus 8% versus 56 plusminus 8% at six months respectively, all P < 0.05. This study suggests that aluminum mobilization following successful renal transplantation may reduce the rate of hemopoiesis.

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