What is your approach to patients with advanced chronic kidney disease who are taking aluminum containing medications?
Do you avoid aluminum-containing medications in patients with advanced chronic kidney disease?
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If taking infrequently would not be all that concerned although there are other options available. Would instruct them to avoid citrate-containing medications such as Bicitra due to their enhancing Al absorption from the GI tract.
Although aluminum toxicity is not as much of a concern as it was in the 1980s among dialysis patients, I still believe we need to do everything possible to avoid it. There are a significant number of alternatives to Maalox and as such it should not be used in patients with advanced CKD. Until about 20 years ago, I had used short courses of Amphojel to treat severe hyperphosphatemia among patients with advanced CKD with some success. However, recently with all the new phosphorus binders, I find the above practice no longer relevant.