Portal de Periódicos da CAPES

Adverse Effects of Aluminum-Containing Antacids on Mineral Metabolism

1979; Elsevier BV; Volume: 76; Issue: 3 Linguagem: Inglês

10.1016/s0016-5085(79)80232-2

1528-0012

Herta Spencer, M Lender,

Digestive system and related health

The beneficial effects of aluminum-containing ant­ acids for the treatment of peptic ulcer are well rec­ ognized. However, these antacids can cause adverse reactions. It is the aluminum which interacts in the intestine with anions, such as phosphate and fluo­ ride, and affects the absorption of these dietary and possibly also endogenously secreted elements. Aluminum forms insoluble complexes with the diet­ ary phosphate which becomes unavailable for ab­ sorption. In addition to the interaction of aluminum with the dietary phosphate and fluoride, the absorp­ tion of aluminum from these antacids and the depo­ sition of aluminum in various tissues has been re­ ported in recent years. The biologic consequences of the interaction of aluminum with dietary phosphorus in animals have been reported almost half a century ago,l and similar effects were reported in humans as long as four dec­ ades ago!-4 Relatively large amounts of antacids in­ creased the fecal phosphorus excretion, decreased urinary phosphorus, and increased urinary calcium excretion. This inhibition of the intestinal absorp­ tion of phosphorus suggested the therapeutic use of aluminum hydroxide for preventing the recurrence of phosphate-containing kidney stones. 5 Although inhibition of phosphorus absorption and the associ­ ated hypercalciuria have been clearly demonstrated, these early observations were not related to the pos­ sible adverse effects of aluminum-containing ant­ acids on bone and to the potential development of skeletal demineralization. It was not until 1960 that severe bone pain, osteomalacia, and pseudofractures were attributed to chronic ingestion of large amounts of aluminum hydroxide for several years.6 Shortly thereafter, the intake of large amounts of aluminum-containing antacids was reported to be associated with the phosphorus depletion syndrome