Treatment of fracturing renal osteodystrophy by desferrioxamine.

Aluminium removal by desferrioxamine chelation has been demonstrated in three long-term haemodialysis patients with dialysis encephalopathy and fracturing renal osteodystrophy. Aluminium concentrations in serum and in both bone marrow and bone trabeculae, determined separately in transiliac biopsy specimens, fell significantly over the treatment period. Bone aluminium removal was confirmed by specific histochemical staining. In two patients osteomalacia disappeared, and in two patients osteitis fibrosa emerged but improved in one following vitamin D therapy. We conclude that desferrioxamine is capable of mobilising aluminium from bone and that the calcification defect in fracturing renal osteodystrophy may be overcome.