What is the role of a serum aluminum measurement in the workup of organ transplantation-related osteoporosis?

Updated: Jul 02, 2020
  • Author: Carmel M Fratianni, MD, FACE; Chief Editor: George T Griffing, MD  more...
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Because the use of aluminum-containing binders in the ESRD population has declined considerably in recent years, a serum aluminum level is optional in patients awaiting renal transplantation.

Such testing should be reserved for dialysis patients in whom aluminum-related bone disease is a likely possibility (ie, patients with renal osteodystrophy and prior exposure to aluminum-containing binders or aluminum-containing dialysate). [80]

The predictive value of serum aluminum values for predicting aluminum-related bone disease has been questioned, [81]  and aluminum staining at the mineralization front on bone biopsy specimens may more accurately reflect the histopathology found in patients on dialysis. [82]

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