Aluminum Toxicity Follow-up

  • Author: Jose F Bernardo, MD, MPH, FASN; Chief Editor: Asim Tarabar, MD   more...
 
Updated: Aug 4, 2010
 

Further Inpatient Care

Start chelation therapy in symptomatic patients with elevated serum aluminum level in consultation with a nephrologist and a medical toxicologist. Use clinical symptoms and serum aluminum levels as indicators of therapeutic success. Reduce exposure to aluminum-containing products.

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Transfer

If chelation therapy and hemodialysis/peritoneal dialysis are not able to be provided, transfer the patient to an institution with a higher level of care.

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Deterrence/Prevention

Avoid all aluminum-containing antacids, antiperspirants, dialysate, immunizations, and TPN solutions.

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Complications

See Clinical.

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Prognosis

Depending upon the degree of dementia and overall medical frailty of the patient, most improve with deferoxamine therapy. Some patients, however, succumb to their underlying disease processes before any noticeable improvement in mental status or anemia occurs. Whether aluminum toxicity itself is fatal is unknown. Typically, patients' underlying diseases and medical frailty lead to early morbidity and mortality.

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Patient Education

Educate pregnant and breastfeeding females, and any patient with compromised renal function, about the use of aluminum-containing antacids and the potential dangers of their use and overuse. A safe alternative includes calcium carbonate, such as found in Tums.

Educate patients to refrain from driving or operating hazardous machinery if they develop dizziness or impaired vision or hearing during treatment.

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Contributor Information and Disclosures
Author

Jose F Bernardo, MD, MPH, FASN  Assistant Professor, Department of Medicine, Renal-Electrolyte Division, University of Pittsburgh

Jose F Bernardo, MD, MPH, FASN is a member of the following medical societies: American Society of Nephrology and American Society of Transplantation

Disclosure: Nothing to disclose.

Coauthor(s)

Michael R Edwards, MD  Physician, Department of Emergency Medicine, Beebe Medical Center; Physician, Department of Emergency Medicine, Catholic Medical Center

Michael R Edwards, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and American College of Physician Executives

Disclosure: Nothing to disclose.

Barbara Barnett, MD  Associate Program Director, Assistant Professor, Department of Emergency Medicine, Albert Einstein College of Medicine

Barbara Barnett, MD is a member of the following medical societies: American Academy of Emergency Medicine, American Medical Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Lisa Kirkland, MD, FACP, CNSP, MSHA  Assistant Professor, Department of Internal Medicine, Division of Hospital Medicine, Mayo Clinic; ANW Intensivists, Abbott Northwestern Hospital

Lisa Kirkland, MD, FACP, CNSP, MSHA is a member of the following medical societies: American College of Physicians, Society of Critical Care Medicine, and Society of Hospital Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Harold L Manning, MD  Associate Professor, Departments of Medicine, Anesthesiology and Physiology, Section of Pulmonary and Critical Care Medicine, Dartmouth Medical School

Harold L Manning, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and American Thoracic Society

Disclosure: Nothing to disclose.

Timothy D Rice, MD  Associate Professor, Departments of Internal Medicine and Pediatrics and Adolescent Medicine, St Louis University School of Medicine

Timothy D Rice, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Physicians

Disclosure: Nothing to disclose.

Chief Editor

Asim Tarabar, MD  Assistant Professor, Director, Medical Toxicology, Department of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital

Disclosure: Nothing to disclose.

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