Efficacy of intramuscular and intraperitoneal deferoxamine for aluminium chelation

Bruce Molitoris, P. S. Alfrey, N. L. Miller, J. A. Hasbargen, W. D. Kaehney, B. J. Smith

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

As intravenous administration of deferoxamine is difficult in home dialysis patients we set out to determine the efficacy of intramuscular (i.m.) and intraperitoneal (i.p.) deferoxamine for removal of aluminium. Patients with serum aluminium levels greater than 90 μg/liter were studied in a paired fashion with each patient serving as their own control. Serum and peritoneal fluid aluminium were determined using flameless atomic absorption. In hemodialysis patients 2 g of intravenous deferoxamine increased serum aluminium from 124.7 ± 32.4 to 415 ± 192.4 μg/liter. One g of deferoxamine given intravenously or intramuscularly resulted in 76.8 ± 35.3% and 70.4 ± 23.2%, respectively, of the 2 g i.v. response. The rate at which serum aluminium increased following i.v. deferoxamine infusion was biphasic, with an initial rapid phase lasting 139 minutes followed by a much slower phase. The volume of distribution of aluminium following deferoxamine administration was 12.6 ± 1.61 and the half-life (t 1/2 ) for aluminium removal during hemodialysis was 9.0 ± 2.0 hours. The increase in serum aluminium following deferoxamine was not due to chelation of erythrocyte aluminium as erythrocyte aluminium remained constant over 24 hours. In patients on continuous ambulatory peritoneal dialysis, 2 g intravenous deferoxamine resulted in the removal of 560 ± 267 μg of aluminium over 24 hours while 2 g deferoxamine given intraperitoneally gave 91 ± 13% of the intravenous response. Aluminium clearance over 48 hours was twice that for 24 hours for both i.v. and i.p. deferoxamine. These results indicate that aluminium is chelated rapidly from tissues other than erythrocytes, and i.m. deferoxamine in hemodialysis patients and i.p. deferoxamine in CAPD patients is as efficacious and potentially safer than intravenously administered deferoxamine.

Original languageEnglish
Pages (from-to)986-991
Number of pages6
JournalKidney International
Volume31
Issue number4
StatePublished - 1987
Externally publishedYes

Fingerprint

Deferoxamine
Aluminum
Renal Dialysis
Serum
Continuous Ambulatory Peritoneal Dialysis
Erythrocytes
Ascitic Fluid
Intravenous Administration
Half-Life
Dialysis

ASJC Scopus subject areas

  • Nephrology

Cite this

Molitoris, B., Alfrey, P. S., Miller, N. L., Hasbargen, J. A., Kaehney, W. D., & Smith, B. J. (1987). Efficacy of intramuscular and intraperitoneal deferoxamine for aluminium chelation. Kidney International, 31(4), 986-991.

Efficacy of intramuscular and intraperitoneal deferoxamine for aluminium chelation. / Molitoris, Bruce; Alfrey, P. S.; Miller, N. L.; Hasbargen, J. A.; Kaehney, W. D.; Smith, B. J.

In: Kidney International, Vol. 31, No. 4, 1987, p. 986-991.

Research output: Contribution to journalArticle

Molitoris, B, Alfrey, PS, Miller, NL, Hasbargen, JA, Kaehney, WD & Smith, BJ 1987, 'Efficacy of intramuscular and intraperitoneal deferoxamine for aluminium chelation', Kidney International, vol. 31, no. 4, pp. 986-991.
Molitoris B, Alfrey PS, Miller NL, Hasbargen JA, Kaehney WD, Smith BJ. Efficacy of intramuscular and intraperitoneal deferoxamine for aluminium chelation. Kidney International. 1987;31(4):986-991.
Molitoris, Bruce ; Alfrey, P. S. ; Miller, N. L. ; Hasbargen, J. A. ; Kaehney, W. D. ; Smith, B. J. / Efficacy of intramuscular and intraperitoneal deferoxamine for aluminium chelation. In: Kidney International. 1987 ; Vol. 31, No. 4. pp. 986-991.
@article{520edf408a10407586e2aab56d071b46,
title = "Efficacy of intramuscular and intraperitoneal deferoxamine for aluminium chelation",
abstract = "As intravenous administration of deferoxamine is difficult in home dialysis patients we set out to determine the efficacy of intramuscular (i.m.) and intraperitoneal (i.p.) deferoxamine for removal of aluminium. Patients with serum aluminium levels greater than 90 μg/liter were studied in a paired fashion with each patient serving as their own control. Serum and peritoneal fluid aluminium were determined using flameless atomic absorption. In hemodialysis patients 2 g of intravenous deferoxamine increased serum aluminium from 124.7 ± 32.4 to 415 ± 192.4 μg/liter. One g of deferoxamine given intravenously or intramuscularly resulted in 76.8 ± 35.3{\%} and 70.4 ± 23.2{\%}, respectively, of the 2 g i.v. response. The rate at which serum aluminium increased following i.v. deferoxamine infusion was biphasic, with an initial rapid phase lasting 139 minutes followed by a much slower phase. The volume of distribution of aluminium following deferoxamine administration was 12.6 ± 1.61 and the half-life (t 1/2 ) for aluminium removal during hemodialysis was 9.0 ± 2.0 hours. The increase in serum aluminium following deferoxamine was not due to chelation of erythrocyte aluminium as erythrocyte aluminium remained constant over 24 hours. In patients on continuous ambulatory peritoneal dialysis, 2 g intravenous deferoxamine resulted in the removal of 560 ± 267 μg of aluminium over 24 hours while 2 g deferoxamine given intraperitoneally gave 91 ± 13{\%} of the intravenous response. Aluminium clearance over 48 hours was twice that for 24 hours for both i.v. and i.p. deferoxamine. These results indicate that aluminium is chelated rapidly from tissues other than erythrocytes, and i.m. deferoxamine in hemodialysis patients and i.p. deferoxamine in CAPD patients is as efficacious and potentially safer than intravenously administered deferoxamine.",
author = "Bruce Molitoris and Alfrey, {P. S.} and Miller, {N. L.} and Hasbargen, {J. A.} and Kaehney, {W. D.} and Smith, {B. J.}",
year = "1987",
language = "English",
volume = "31",
pages = "986--991",
journal = "Kidney International",
issn = "0085-2538",
publisher = "Nature Publishing Group",
number = "4",

}

TY - JOUR

T1 - Efficacy of intramuscular and intraperitoneal deferoxamine for aluminium chelation

AU - Molitoris, Bruce

AU - Alfrey, P. S.

AU - Miller, N. L.

AU - Hasbargen, J. A.

AU - Kaehney, W. D.

AU - Smith, B. J.

PY - 1987

Y1 - 1987

N2 - As intravenous administration of deferoxamine is difficult in home dialysis patients we set out to determine the efficacy of intramuscular (i.m.) and intraperitoneal (i.p.) deferoxamine for removal of aluminium. Patients with serum aluminium levels greater than 90 μg/liter were studied in a paired fashion with each patient serving as their own control. Serum and peritoneal fluid aluminium were determined using flameless atomic absorption. In hemodialysis patients 2 g of intravenous deferoxamine increased serum aluminium from 124.7 ± 32.4 to 415 ± 192.4 μg/liter. One g of deferoxamine given intravenously or intramuscularly resulted in 76.8 ± 35.3% and 70.4 ± 23.2%, respectively, of the 2 g i.v. response. The rate at which serum aluminium increased following i.v. deferoxamine infusion was biphasic, with an initial rapid phase lasting 139 minutes followed by a much slower phase. The volume of distribution of aluminium following deferoxamine administration was 12.6 ± 1.61 and the half-life (t 1/2 ) for aluminium removal during hemodialysis was 9.0 ± 2.0 hours. The increase in serum aluminium following deferoxamine was not due to chelation of erythrocyte aluminium as erythrocyte aluminium remained constant over 24 hours. In patients on continuous ambulatory peritoneal dialysis, 2 g intravenous deferoxamine resulted in the removal of 560 ± 267 μg of aluminium over 24 hours while 2 g deferoxamine given intraperitoneally gave 91 ± 13% of the intravenous response. Aluminium clearance over 48 hours was twice that for 24 hours for both i.v. and i.p. deferoxamine. These results indicate that aluminium is chelated rapidly from tissues other than erythrocytes, and i.m. deferoxamine in hemodialysis patients and i.p. deferoxamine in CAPD patients is as efficacious and potentially safer than intravenously administered deferoxamine.

AB - As intravenous administration of deferoxamine is difficult in home dialysis patients we set out to determine the efficacy of intramuscular (i.m.) and intraperitoneal (i.p.) deferoxamine for removal of aluminium. Patients with serum aluminium levels greater than 90 μg/liter were studied in a paired fashion with each patient serving as their own control. Serum and peritoneal fluid aluminium were determined using flameless atomic absorption. In hemodialysis patients 2 g of intravenous deferoxamine increased serum aluminium from 124.7 ± 32.4 to 415 ± 192.4 μg/liter. One g of deferoxamine given intravenously or intramuscularly resulted in 76.8 ± 35.3% and 70.4 ± 23.2%, respectively, of the 2 g i.v. response. The rate at which serum aluminium increased following i.v. deferoxamine infusion was biphasic, with an initial rapid phase lasting 139 minutes followed by a much slower phase. The volume of distribution of aluminium following deferoxamine administration was 12.6 ± 1.61 and the half-life (t 1/2 ) for aluminium removal during hemodialysis was 9.0 ± 2.0 hours. The increase in serum aluminium following deferoxamine was not due to chelation of erythrocyte aluminium as erythrocyte aluminium remained constant over 24 hours. In patients on continuous ambulatory peritoneal dialysis, 2 g intravenous deferoxamine resulted in the removal of 560 ± 267 μg of aluminium over 24 hours while 2 g deferoxamine given intraperitoneally gave 91 ± 13% of the intravenous response. Aluminium clearance over 48 hours was twice that for 24 hours for both i.v. and i.p. deferoxamine. These results indicate that aluminium is chelated rapidly from tissues other than erythrocytes, and i.m. deferoxamine in hemodialysis patients and i.p. deferoxamine in CAPD patients is as efficacious and potentially safer than intravenously administered deferoxamine.

UR - http://www.scopus.com/inward/record.url?scp=0023116953&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023116953&partnerID=8YFLogxK

M3 - Article

C2 - 3586503

AN - SCOPUS:0023116953

VL - 31

SP - 986

EP - 991

JO - Kidney International

JF - Kidney International

SN - 0085-2538

IS - 4

ER -