This drug can cause Aluminum toxicity in patients with renal failure. Which drug is it?

• A. Sucralfate
• B. Bismuth subgallate
• C. Lactulose
• D. Docusate sodium

Answer: (A)

Aluminum-containing drugs can build up when kidney function is poor, because the body can’t clear aluminum efficiently. Sucralfate is a complex that includes aluminum hydroxide. In renal failure, even this largely unabsorbed aluminum can accumulate and cause aluminum toxicity, which may show up as neurologic symptoms (enlarged risk of encephalopathy), bone disease like osteomalacia, and anemia. That’s why this drug carries a toxicity risk in patients with renal impairment. The other options don’t contain aluminum, so they don’t pose this specific risk.