Aluminum loading during total parenteral nutrition.

Patients on long-term total parenteral nutrition were found to have elevated aluminum (AI) levels in bone, and plasma, with the casein in the total parenteral nutrition solution the source of A1. Substitution of amino acids for casein was followed by a fall in urinary and plasma A1. Thus, parenteral loading with A1 increases tissue A1, particularly in bone. Whether A1 accumulation contributes to bone disease remains unclear, but the prolonged use of casein in total parenteral nutrition solutions may be inadvisable.