Journal Article

Mobilization of lead from bone in end-stage renal failure patients with secondary hyperparathyroidism

Michèle Kessler, Pierre Y. Durand, Than Cao Huu, M. José Royer-Morot, Jacques Chanliau, Patrick Netter and Michel Duc

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 14, issue 11, pages 2731-2733
Published in print November 1999 | ISSN: 0931-0509
Published online November 1999 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/14.11.2731
Mobilization of lead from bone in end-stage renal failure patients with secondary hyperparathyroidism

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Background. It is now recognized that long-term exposure to even low levels of lead may increase bone lead content. Lead can then be released in toxicologically significant amounts during critical states of increased bone turnover.

Methods. Two patients with end-stage renal failure, one on haemodialysis and the other on continuous ambulatory peritoneal dialysis (CAPD), had been exposed to lead and developed secondary hyperparathyroidism. An edetate calcium disodium (EDTA) test was performed in combination with haemofiltration or CAPD before and after parathyroidectomy.

Results. Before parathyroidectomy, both patients had low delta aminolaevulinic acid dehydrase (ALA-D) and high concentrations of chelated lead. After parathyroidectomy, there was a dramatic decrease in chelated lead and the ALA-D returned to normal.

Conclusion. Secondary hyperparathyroidism increases mobilization of bone lead in dialysis patients with an elevated lead burden. This may cause toxic effects.

Keywords: end-stage renal failure; haemodialysis; lead poisoning; peritoneal dialysis; secondary hyperparathyroidism

Journal Article.  1481 words.  Illustrated.

Subjects: Nephrology

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