Effect of desferrioxamine on removal of aluminum and iron by coated charcoal haemoperfusion and haemodialysis.

An intravenous infusion of desferrioxamine (3 g) was given to 17 chronic renal failure patients stabilised on standard haemodialysis. Aluminium clearance 48 h after desferrioxamine was 65.3 +/- 11.0 ml/min for 'Dialaid 4000' with 70 g coated charcoal haemoperfusion system; 44.6 +/- 13.7 ml/min for 'Rhondial 75' with polyacrylonitrate membrane; 35.8 +/- 11.0 ml/min for 'Monitral' with polyacrylonitrate membrane; and 4.0 +/- 17.8 ml/min for haemodialysers with a 'Cupraphane' membrane. None of these 4 systems removed any aluminium in the absence of desferrioxamine in the same patients. Even at a desferrioxamine concentration of 40 mg/dl, coated activated charcoal (CAC) was not saturated. CAC did not absorb ferric ions in vitro. But when 40 mg/dl of desferrioxamine was present CAC absorbed increasing concentrations of ferric ions in a linear fashion.