Does aluminum have a pathogenic role in dialysis associated arthropathy?

Article Abstract:

Dialysis improves the quality of life of patients with chronic kidney disease; however, complications can occur in patients undergoing long-term dialysis. Aluminum is found in the phosphate binding gels that are used to lower increased phosphate levels (hyperphosphatemia) in dialysis patients, and it is also found in the dialysis solutions. This element is toxic to organs and tissues, particularly to nerve tissue and bone, and it has been implicated as the cause of arthropathy (joint disease) in dialysis patients. To reduce aluminum overload, aluminum concentrations in dialysis solutions have been lowered, and patient blood aluminum levels are routinely monitored. Dialysis-associated arthropathy is usually a crippling disorder seen in patients after 10 years of maintenance dialysis. The clinical features are carpal tunnel syndrome and joint disease of the spine and extremities. Deposits of aluminum can be visualized by X-ray after accumulation in the joint structures. Laboratory analysis of aluminum concentrations in dialysis patients has revealed that patients with joint disease have the highest amounts of aluminum. Furthermore, studies in animals have demonstrated an inflammatory effect of aluminum when it is injected into their extremities, and the features resemble those of patients with chronic kidney disease receiving hemodialysis and treated with aluminum compounds. Investigators need to continue to study dialysis-associated arthropathy to define each factor in the development of this disorder and to further confirm the toxicity of aluminum to joints. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Measurement, Aluminum, Aluminum (Metal), Dialysis, Dialysis (Chemical process), Aluminum in the body, Aluminum (Nutrient)

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Where are peripheral analgesics acting?

Article Abstract:

Peripheral analgesics, or pain relievers that act upon peripheral tissues, may also provide central pain relief in patients suffering from chronic rheumatic diseases. Chronic rheumatic diseases are a group of inflammatory disorders that cause pain, deformities and progressive disability. Non-narcotic analgesics used to treat patients with chronic rheumatic diseases include aspirin and other non-steroidal anti-inflammatory drugs. These drugs lower fever and reduce inflammation in damaged tissues in addition to providing pain relief. Aspirin-like drugs may also act on the central nervous system to provide overall pain relief. These drugs appear to act on receptors in the nociceptive system to counteract pain messages. Aspirin-like drugs also decrease prostaglandin synthesis in different types of tissue, which may enhance the central analgesic effect.

Drug therapy, Nonsteroidal anti-inflammatory drugs, Nonsteroidal anti-inflammatory agents, Rheumatic diseases, Analgesics

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Amyloid, advanced glycation end products, and dialysis related arthropathy

Article Abstract:

Long-term hemodialysis almost always results in dialysis-related arthropathy (DRA), a syndrome of joint pain and stiffness caused by beta 2-microglobulin deposition. Chronic kidney disease reduces the clearance of beta 2-microglobulin from the blood, and dialysis increases the production of this protein. Deposits of the amyloid protein in joint spaces causes inflammation and joint damage. Kidney transplantation is curative, and hemodiafiltration and high flux dialysis membranes can reduce circulating beta 2-microglobulin levels.

Amyloidosis, Immunoglobulins, Hemodialyzers, Hemodialysis equipment, Hemodialysis

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