What is Aluminium Blood test? 

Aluminium is a mineral present in the body without a clear biological role. It enters the body through food (the daily intake of aluminium from diet ranges from five to 10 milligrams), water, medicines and through skin. Normally, all of this aluminium is excreted in the urine. However, regular and long term exposure to this metal may make it difficult for the body to excrete it out completely. This excess aluminium then starts to accumulate in various tissues, particularly in bones, brain and parathyroid glands, leading to aluminium toxicity. 

Mineworkers or people who work in aluminium industry are at high risk of toxicity from this metal

Additionally, patients with kidney damage are not able to excrete out all the aluminium from their bodies and are at risk of toxicity. 

Some other factors that may lead to aluminium toxicity in people suffering from renal failure are:

  • When the dialysis process is not very effective in removing aluminium from the blood
  • When aluminium is absorbed from oral medications such as antacids with aluminium hydroxide
  • When the dialysis fluid has aluminium traces present in it

An aluminium test is ordered to assess aluminium toxicity caused due to any of the above-mentioned reasons. It is also done as a routine test to measure the concentration of aluminium in the blood of a renal failure patient.

  1. Why is an Aluminium Blood test performed?
  2. How do you prepare for an Aluminium Blood test?
  3. How is an Aluminium Blood test performed?
  4. Aluminium Blood test results and normal levels

An aluminium blood test is primarily done to check for aluminium toxicity in the body. Doctors recommend this test in:

  • Patients with kidney failure who are unable to excrete aluminium (Read more: Acute kidney failure)
  • Those who are undergoing regular haemodialysis as a treatment for kidney failure 
  • Those who suffer from poor iron absorption and anaemia
  • People living or working in places that contain high levels of aluminium 
  • Those receiving long-term intravenous nutrition
  • People who have aluminium containing prosthetic implants, such as hip replacements 
  • Those who are taking citrate-containing drugs or aluminium-containing astringents, hydroxide gels, aluminium-containing phosphate binders.

The test is also recommended for those who suffer from secondary hyperparathyroidism due to aluminium accumulation in bones. Parathyroid hormone regulates blood calcium levels. Aluminium increases calcium in blood, so more parathyroid hormone is needed to balance it.

Additionally, your doctor may order this test if you display the following symptoms of aluminium toxicity:

Certain complications associated with aluminium toxicity are:

  • Bone diseases
  • Brain diseases 
  • Lung diseases
  • Anaemia and impaired iron absorption 
  • Nervous system disorders
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No special preparation is required before this test. Inform your doctor about all the drugs, supplements and vitamins that you are consuming.

Your doctor may administer a dose of intravenous deferoxamine before the test to release the bound aluminium from different tissues.

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For this test, a skilled technician will withdraw 6 mL of blood from a vein in your arm.

You may experience pain or soreness at the site of insertion of the needle. However, it will subside soon. The sample will be sent for analysis immediately. For those undergoing dialysis, the dialysis centre will collect a blood sample and send it for analysis.

Results are generally expected in three weeks.

Normal results:

The following concentrations of aluminium in the blood are considered as normal:

  • Concentration < 0.37 µmol/L is normal in persons with no history of chronic renal failure
  • Concentration < 2.22 µmol/L in patients with chronic renal failure who are receiving dialysis

Abnormal results:

The following levels can be considered as abnormal in patients who have been receiving dialysis:

  • Concentrations > 2.22 µmol/L indicate excessive accumulation of aluminium.
  • Concentrations > 3.70 µmol/L indicate a high risk of toxicity in children and is a matter of concern.
  • Concentrations > 7.41 µmol/L are considered high in both children and adults and require urgent care.

Since abnormal results are primarily noted in patients having chronic kidney disease, the following complications of aluminium toxicity are seen in these patients:

  • Lung disease
  • Microcytic anaemia
  • Dialysis dementia, characterised by memory impairment and cognitive disabilities in younger ages (earlier than normal)
  • Aluminium-induced osteomalacia where bones are deformed and fragile, resulting in frequent fractures.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.

References

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  2. Marshall WJ, Lapsley M, Day AP, Ayling RM. Clinical Biochemistry: Metabolic and Clinical Aspects. Metabolic bone disease. 3rd ed. 2014. Churchill Livingstone, Elsevier Ltd. Pp: 625-627.
  3. South Tees Hospitals. NHS Foundation trust. National Health Service, U.K. Aluminium
  4. McCarthy JT, Milliner DS, Kurtz SB, et al. Interpretation of serum aluminum values in dialysis patients. Am J Clin Pathol 1986;86:629-636. PMID: 3776914
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  11. D’Haese PC, Couttenye MM, Goodman WG, et al. Use of the low-dose desferrioxamine test to diagnose and differentiate between patients with aluminum-related bone disease, increased risk for aluminum toxicity, or aluminium overload. Nephrol Dial Transplant. 1995;10:1874-1884. PMID: 8592597
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  16. Molloy DW, Standish TI, Nieboer E et al. Effects of acute exposure to aluminum on cognition in humans. J Toxicol Environ Health A 2007:70(23):2011-2019. PMID: 17966072
  17. Agency for Toxic Substances and Disease Registry [internet]. Center for Disease Control. Atlanta. GA. U.S. ToxFAQsTM for Aluminum
  18. Morbidity and Mortality Weekly Report. Centers for Disease Control and Prevention: U.S. Department of Health and Human Services; Elevated Serum Aluminum Levels in Hemodialysis Patients Associated with Use of Electric Pumps --- Wyoming, 2007
  19. Mahieu S, del Carmen Contini M, González M, Millen N, Elias MM. Aluminum toxicity. Hematological effects. Toxicol Lett. 2000;111(3):235-242. doi:10.1016/S0378-4274(99)00184-8.
  20. Mahieu S, del Carmen Contini M, González M, Millen N, Elias MM. Aluminum toxicity. Hematological effects. Toxicol Lett. 2000;111(3):235-242. doi:10.1016/S0378-4274(99)00184-8.
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  22. Gloucestershire Hospitals. NHS Foundation trust. National Health Service, U.K. Aluminium (Al)
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