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The Effect of Oral Bases on Enteral Aluminum Absorption
John A. Walker, MD;
Richard A. Sherman, MD;
Ronald P. Cody, EdD
Arch Intern Med. 1990;150(10):2037-2039.
Abstract
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• Physicochemical considerations suggest that citrate may potentiate gastrointestinal aluminum absorption via the formation of an aluminum citrate moiety. We tested this hypothesis and also studied whether sodium bicarbonate would have a similar effect. Eight healthy adults each partook of four oral regimens: aluminum alone, aluminum plus sodium bicarbonate, aluminum plus citrate (as Shohl's solution), and citrate alone. Twenty-four hour urine collections were obtained immediately preceeding and during the second day of each medication period for determination of aluminum content. A significant but similar increment in urinary aluminum occurred with both aluminum alone and aluminum plus sodium bicarbonate, while only a small increment was noted with Shohl's solution alone. The rise in urinary aluminum obtained with aluminum plus Shohl's solution, however, was nearly eight times that seen with either aluminum alone or aluminum plus sodium bicarbonate (327 µg vs 45 µg and 41 µg, respectively). Citrate thus appears to augment gastrointestinal aluminum absorption markedly, an effect not shared by an equivalent dose of sodium bicarbonate. Citrate administration to patients with renal failure who are also taking aluminum-containing medication may be harmful.
(Arch Intern Med. 1990;150:2037-2039)
Author Affiliations
From the Department of Medicine, Division of Nephrology and the Department of Environmental and Community Medicine, University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School, New Brunswick.
Footnotes
Accepted for publication March 30,1990.
This work has been published in part in abstract form in the Proceedings of the 10th International Congress of Nephrology, London, England, July 26-31, 1987.
Reprint requests to the Department of Medicine, University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School CN-19, New Brunswick, NJ 08903-0019 (Dr Walker).
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