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Serum aluminum levels in dialysis patients after sclerotherapy of internal hemorrhoids with aluminum potassium sulfate and tannic acid

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Abstract

Purpose

Aluminum potassium sulfate and tannic acid (ALTA) is an effective sclerosing agent for internal hemorrhoids. However, it is contraindicated for patients with chronic renal failure on dialysis, because the aluminum in ALTA can cause aluminum encephalopathy when it is not excreted effectively. We conducted this study to measure the serum aluminum concentrations and observe for symptoms relating to aluminum encephalopathy in dialysis patients after ALTA therapy.

Methods

Ten dialysis patients underwent ALTA therapy for hemorrhoids. We measured their serum aluminum concentrations and observed them for possible symptoms of aluminum encephalopathy.

Results

The total injection volume of ALTA solution was 31 mL (24–37). The median serum aluminum concentration before ALTA therapy was 9 μg/L, which increased to 741, 377, and 103 μg/L, respectively, 1 h, 1 day, and 1 week after ALTA therapy. These levels decreased rapidly, to 33 μg/L by 1 month and 11 μg/L by 3 months after ALTA therapy. No patient suffered symptoms related to aluminum encephalopathy.

Conclusions

Although the aluminum concentrations increased temporarily after ALTA therapy, dialysis patients with levels below 150 μg/L by 1 week and thereafter are considered to be at low risk of the development of aluminum encephalopathy.

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Conflict of interest

Akira Tsunoda and his co-authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Surgery, Kameda Medical Center, 929 Higasicho, Kamogawa, Chiba, 296-8602, Japan

    Akira Tsunoda & Nobuyasu Kano

  2. Department of Surgery, Awa Regional Medical Center, Tateyama, Japan

    Akira Tsunoda, Masafumi Nakagi & Masahiko Mizutani

  3. Department of Nephrology, Awa Regional Medical Center, Tateyama, Japan

    Kenji Yamaguchi

Authors
  1. Akira Tsunoda
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  2. Masafumi Nakagi
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  3. Nobuyasu Kano
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  4. Masahiko Mizutani
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  5. Kenji Yamaguchi
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Correspondence to Akira Tsunoda.

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Tsunoda, A., Nakagi, M., Kano, N. et al. Serum aluminum levels in dialysis patients after sclerotherapy of internal hemorrhoids with aluminum potassium sulfate and tannic acid. Surg Today 44, 2314–2317 (2014). https://doi.org/10.1007/s00595-014-0914-4

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  • DOI: https://doi.org/10.1007/s00595-014-0914-4

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