Aluminium (Al)

Chemical Pathology

Notes

Aluminium is widely distributed but only a very small fraction is absorbed by the GI tract and under normal circumstances this is completely eliminated by the kidneys.

Patients with renal failure (eGFR <30 ml/min) lose the ability to clear aluminium via their kidneys. Renal dialysis is very ineffective at removing aluminium due to protein binding, so these patients can be at risk of toxicity if intake is not kept low. Aluminium is now however very effectively removed from dialysis water by reverse osmosis.

Phosphate binders can also be a source of aluminium but the introduction of non-aluminium containing binders has reduced this issue.

As a result the analysis of aluminium is only occasionally required, please refer to current UK Renal Association guidelines for more details.

Sample requirements

For adults, at least 2 ml of blood taken into a dark blue top trace element tube.

Storage/transport

Send at ambient temperature to the laboratory. If unavoidable can be stored refrigerated overnight.

Required information

Relevant clinical details including if collected pre or post dialysis.

Turnaround times

The samples are sent to King's College Hospital for analysis with results expected back within 3 weeks.

Reference ranges

Normal range in patients with no history of CRF: <0.40 µmol/L

Levels are expected to be higher in patients with CRF, see guidelines for specific targets and action limits.

Further information

UK Renal Association guidelines

NICE [CG157] Chronic kidney disease (stage 4 or 5): management of hyperphosphataemia

For clinicians with access to Up-To-Date, see the following article for information on Aluminum toxicity in chronic kidney disease: Aluminium Toxicity

Page last updated: 04/08/2023