What is your approach to patients with advanced chronic kidney disease who are taking aluminum containing medications?  

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 ...