From the Guidelines
Maalox (aluminum hydroxide) can potentially affect renal function, particularly with long-term use or in patients with existing kidney disease. Aluminum from this antacid can accumulate in the body when kidney function is impaired, potentially leading to aluminum toxicity, as noted in studies such as 1. This is most concerning in patients with chronic kidney disease or those on dialysis. Short-term use of Maalox at recommended doses is generally safe for people with normal kidney function, but prolonged use should be avoided. The aluminum can form insoluble complexes with phosphate in the gut, potentially causing hypophosphatemia with extended use, a concern highlighted in guidelines like those found in 1. Additionally, aluminum hydroxide can cause constipation as a side effect.
For patients with kidney disease, alternative antacids without aluminum (such as calcium-based antacids) or acid suppressants like H2 blockers or proton pump inhibitors may be safer options, as suggested by the clinical practice guidelines outlined in 1. Any patient with kidney disease should consult their healthcare provider before using aluminum-containing antacids regularly. The potential for aluminum toxicity and its impact on renal function, especially in vulnerable populations like those with chronic kidney disease, underscores the importance of careful consideration and monitoring, as discussed in 1 and 1.
Key considerations include:
- The risk of aluminum accumulation and toxicity with impaired renal function
- The potential for hypophosphatemia and other electrolyte imbalances
- The importance of alternative treatments for patients with kidney disease
- The need for healthcare provider consultation before using aluminum-containing antacids in patients with renal issues.
From the Research
Maalox and Renal Function
- Maalox, which contains aluminum hydroxide, may affect renal function, particularly in patients with pre-existing renal impairment 2, 3, 4, 5.
- Aluminum toxicity is a concern in patients with chronic renal failure, as the kidneys are unable to effectively excrete aluminum, leading to accumulation in the body 3, 5.
- Studies have shown that aluminum-containing antacids, such as Maalox, can increase aluminum levels in the blood and contribute to aluminum-related bone disease in patients with chronic renal failure 2, 4.
- The use of aluminum hydroxide as a phosphate-binding agent in patients with chronic renal failure has been associated with aluminum retention and toxicity 4.
- However, it is worth noting that one study found that meloxicam, a non-steroidal anti-inflammatory drug, did not further compromise renal function in patients with mild renal impairment, but this study did not involve Maalox or aluminum hydroxide 6.
Key Findings
- Aluminum hydroxide can increase aluminum levels in the blood and contribute to aluminum-related bone disease in patients with chronic renal failure 2, 4.
- Patients with chronic renal failure are at risk of aluminum toxicity due to impaired renal excretion of aluminum 3, 5.
- The use of aluminum-containing antacids, such as Maalox, should be carefully considered in patients with renal impairment, and alternative phosphate-binding agents may be preferred 4.