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Red blood cell (RBC) aluminum (Al) in patients with renal failure on different treatments was studied. Nondialyzed renal failure patients had high levels of RBC Al, but low serum Al levels. However, their RBC Al levels were lower than those of patients on hemodialysis (HD) and continuous ambulatory peritoneal dialysis. In addition, HD patients who were not given Al-containing medications showed high levels of RBC Al, which suggests that there may be a source of Al other than medications. When desferrioxamine (DFO) was administered to these HD patients, the changes in RBC Al levels after DFO infusion were independent of those in serum Al levels and blood hemoglobin levels. In an in vitro study, RBC Al was removed using an ultrafiltration membrane, which showed that RBC Al exists in a bound form. These results suggest that Al accumulates in RBCs of renal failure patients independently of serum Al levels, and that the improvement of anemia by DFO may not be due to the direct removal of RBC Al.
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