Abstract
120 hemodialyzed patients were studied to establish a non-invasive method for the diagnosis of Al-related bone disease and to determine the treatment efficacy of defero-xamin (DFO) administration for relief of bone pain. DFO in the amount of 40 mg/kg body weight was infused into the venous line during the last hour of dialysis session. Blood samples were collected at the start of the first and the next dialysis. Differences in serum Al concentrations of pre-DFO infusion and post-DFO were determined as ΔAl. In patients without bone pain, a signifficant correlation between ΔAl and dialysis duration was found (y=88.8+0.676x, n=49, r=0.55), but there was none between basal Al level and dialysis duration. Both basal and A A1 levels in patients with bone pain showed no signifficant correlation with dialysis duration. However, 63 out of 68 patients with bone pain placed above the regression line of those without pain. These data indicated the DFO loading test to be clinically applicable to the diagnosis of Al-related bone disease as a non-invasive diagnostic method. 63 patients on chronic dialysis complaining of continuous bone pain and whose ΔAl exceeded 150 μg/L were administered by DFO therapy. Δ Al rapidly decreased a mean average of 216 μg/L to 90 within 4 weeks. Complete or partial relief of bone pain was experienced by most of patients 4 to 6 weeks following the decrease of ΔAl. The treat-ment was effective for 89% of the patients. During the present study, side effects occured in 7.6% of the patients. One patient was diagnosed as perceptive deafness and the others liver dysfunction. In conclusion, the 2 g DFO loading test is a clinically useful non-invasive metnoa for diagnosis of Al-related bone disease. Several kinds of side effects were evident, but must be carried out with care and caution to relieve bone pain in the patients.
