The use of intravenous and intraperitoneal desferrioxamine in aluminium osteomalacia

A 32-year-old male with aluminium osteomalacia was changed from haemodialysis to chronic ambulatory peritoneal dialysis (CAPD) because of vascular access problems. Desferrioxamine (6 g) was administered intravenously on a once-weekly basis and the quantity of aluminium removed from each dialysate was calculated weekly. Aluminium concentration was estimated using the electrothermal atomic absorption spectrophotometer. The total aluminium removed after one week was 191 mumol, giving a clearance for aluminium of 4.2 ml per min. Subsequently intraperitoneal desferrioxamine 0.5 g per dialysate was administered to a total dose of 6 g and the cumulative aluminium loss was 134.1 mumol giving a clearance of 3.1 ml per min. The weekly loss of aluminium from dialysate when no desferrioxamine was administered was 58.3 mumol, giving a clearance of 2.5 ml per min. This is the first documented comparison of clearance rates for aluminium between CAPD alone, CAPD plus intravenous desferrioxamine and CAPD plus intraperitoneal desferrioxamine.