Only rather recently has the
biologic and pathogenetic relevance of
aluminum, this most common
metal come under serious scientific scrutiny. Various laboratory findings of accumulations of
aluminum in the brain, kidney, liver, parathyroid glands, skeletal muscle, heart, lungs, pancreas and spleen as well as stainable
aluminum in bone have spurred widespread interest in
aluminum absorption and toxicity and in the mechanisms involved in the metabolism of
aluminum. Since the kidney is the major excretory organ for
aluminum, this report focuses on the abnormalities occurring with
aluminum accumulation in the bone of patients with
renal failure to determine the metabolic interrelationships of
aluminum,
parathyroid hormone,
vitamin D,
iron, and
calcium. This editorial presents an overview of the most recent investigations of
aluminum accumulation in humans, experimental animal models, and at the cellular level, presents the metabolic relationships known to exist as well as those strongly suggested in documented studies, and identifies those aspects of
aluminum-related
bone disease awaiting study in this increasingly important field of inquiry. The study outlines the metabolism of
aluminum, the pathogenesis, prevalence, morbidity and mortality of
aluminum-related
bone disease, the histopathology of bone with
aluminum accumulation, the recognized difficulties inherent in the diagnosis of
aluminum-related
bone disease, and the current understanding as relates to prevention and
therapy.