Investigation of Aluminum Poisoning in Patients Undergoing Peritoneal Dialysis and the Effect of Deferoxamine Treatment in Individuals Referred to Khurshid Hospital in Isfahan Between May and July 2024

Background: Aluminum toxicity has been a significant concern in patients with end-stage renal disease (ESRD). Most of the time, aluminum toxicity is an accidental event due to water contamination. Objectives: The present study aimed to discuss aluminum poisoning in peritoneal dialysis patients during 2024. Methods: In this cross-sectional study, patients’ demographic data were extracted from their electronic files. The frequency of signs and symptoms and the efficacy of treatment protocols, based on the national guideline for aluminum poisoning treatment, were investigated. Treatment protocols are based on serum aluminum levels: Twenty to 60 mcg/L, 60 to 200 mcg/L, and more than 200 mcg/L. These protocols include increased peritoneal dialysis sessions with different solutions, hemodialysis, intravenous deferoxamine (DFO), or a combination of these treatments. Results: The study focused on 73 patients undergoing peritoneal dialysis at Khurshid Hospital. Among the 73 patients, 49 (67.1%) were male and 24 (32.9%) were female. The primary cause of ESRD in this group was diabetic nephropathy, affecting 60.3% of the patients. The most common neurological symptom observed was tremor, affecting 21 patients (29%). Weakness and lethargy were reported in 16 patients (22%). Hallucinations occurred in four patients (5.5%), and nine patients (12.3%) experienced restlessness. Sixty-three percent of patients were symptomatic at the beginning of the study, and 93.2% were asymptomatic after eight weeks of appropriate therapy. Conclusions: In individuals with ESRD who are receiving hemodialysis or peritoneal dialysis and present with unusual neurological symptoms and hypotension, the possibility of poisoning with heavy metals or aluminum must be considered. Clinicians should be vigilant for these symptoms.