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Calcium citrate markedly enhances aluminum absorption from aluminum hydroxide.

Abstract
The effect of calcium citrate on intestinal aluminum absorption, assessed by the increment in urinary aluminum excretion, was evaluated in eight normal men. Baseline urinary aluminum excretion was determined for 2 days; thereafter, subjects ingested aluminum hydroxide for 3 days. In a cross-over study, subjects were given either calcium citrate, 950 mg four times a day, or placebo during the 3 days of aluminum hydroxide ingestion (2.4 g/d). Plasma aluminum levels were measured on the second control day and the third day of aluminum hydroxide ingestion. Baseline urinary aluminum excretion was 0.02 +/- 0.004 (6.5 +/- 1.1 micrograms/g creatinine) and 0.03 +/- 0.005 mumol/mmol creatinine (7.4 +/- 1.3 micrograms/g creatinine). These values increased during aluminum hydroxide therapy, but values were much greater when calcium citrate was ingested with aluminum hydroxide. On 3 consecutive days, urinary aluminum excretion levels were 11.1 +/- 3.23, 8.8 +/- 2.9, and 5.3 +/- 0.7 times greater during the administration of calcium citrate with aluminum hydroxide than with aluminum hydroxide alone. Plasma aluminum levels did not differ in the two treatment groups. Thus, calcium citrate markedly enhances the absorption of aluminum from aluminum hydroxide and the two must not be prescribed together in patients with renal failure.
AuthorsJ W Coburn, M G Mischel, W G Goodman, I B Salusky
JournalAmerican journal of kidney diseases : the official journal of the National Kidney Foundation (Am J Kidney Dis) Vol. 17 Issue 6 Pg. 708-11 (Jun 1991) ISSN: 0272-6386 [Print] United States
PMID2042654 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Antacids
  • Citrates
  • Citric Acid
  • Aluminum Hydroxide
  • Aluminum
Topics
  • Adult
  • Aluminum (blood, pharmacokinetics, urine)
  • Aluminum Hydroxide (pharmacokinetics)
  • Antacids (pharmacokinetics)
  • Citrates (pharmacokinetics)
  • Citric Acid
  • Contraindications
  • Drug Synergism
  • Humans
  • Intestinal Absorption (drug effects)
  • Male
  • Middle Aged
  • Reference Values
  • Time Factors

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