Unexpected Serum and Urine Aluminum Concentrations in Pediatric Patients on Home Parenteral Nutrition

The intravenous supply of aluminum (Al) present in parenteral nutrition solutions poses a high risk of the absorption of this element, which can result in metabolic bone disease, anemia, and neurological complications. The aim of this study is to determine the impact of long-term parenteral nutrition (PN) in children on serum Al concentration and its urinary excretion compared to healthy children. We evaluated serum Al concentrations and its urinary excretion in patients enrolled in the Polish home parenteral nutrition (HPN) program between 2004 and 2022. The study group included 83 patients and the control group consisted of 121 healthy children. In children whose PN was started in the neonatal period, we found higher serum Al concentrations and higher urinary Al excretion than in other subjects whose PN was started later. Only 12% of the children on chronic parenteral nutrition had serum Al concentrations of less than 5 mu g/L. Healthy children in the control group had higher serum Al concentrations than those in the parenteral nutrition group, which may indicate the influence of one ' s environment and diet on Al serum levels.

Automated summary

This study aimed to compare the effects of long-term parenteral nutrition in children and healthy children on aluminum concentration and urinary excretion. The study found higher serum aluminum concentrations and urinary aluminum excretion in children who started parenteral nutrition in the neonatal period. Only 12% of children on chronic parenteral nutrition had serum aluminum concentrations below 5 μg/L. Healthy children in the control group had higher serum aluminum concentrations, suggesting the influence of environment and diet on aluminum levels.