I was recently asked to get my Serum Aluminium level tested. This was because I was having low iPTH which was not being corrected even by reducing the Calcium level of my dialysate. Coupled with long standing low WBCs and Platelets, low iPTH could indicate aluminium toxicity.
Sure enough, the lab reported "toxic" levels of Aluminium in my blood. While the normal range is < 15 mcg/L, my level was 73 mcg/L. Above 50 mcg/L was considered toxic.
This can be treated with 'chelation therapy' where a drug is injected in the body 5 hours before dialysis which binds to the Aluminium and allows it to be easily removed by dialysis. This is to be done once a week. The Aluminium level can normalise in 6-8 weeks. Left untreated, it could take a year or more to become normal. And during that time, all kinds of complications can occur including bone pain, fractures, anemia, encephalopathy, confusion, speech difficulty etc.
So it must be treated. I am meeting my nephrologist soon to discuss this.
The question is how did the Aluminium level become this high?
ChatGPT said there are mostly only two ways this can happen. Through the water that is used in dialysis or through medication that I have been on. I use a two-stage RO for my home dialysis. It was unlikely that the aluminium was coming from the water. I gave my list of medication to ChatGPT and asked it to check if any of them had Aluminium. Negative.
What could it be then?
My eye caught something ChatGPT mentioned. It said that Antacids like Sucralfate have Aluminium. Oh damn!
I took Sucralfate for several months after some GI procedures I had earlier this year. Like several, several months! Nobody told me it was harmful for me! ChatGPT says it must not be given to dialysis patients. And if there is no alternate, it must be given for short durations with close monitoring of Aluminium levels.
While I am in the process of getting the RO water for my home dialysis tested, it does look like Sucralfate is the culprit. I will keep you posted.
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