High levels of aluminum in drinking water can lead to which medical condition?

High levels of aluminum in drinking water are most closely associated with bone disease, particularly in individuals with renal impairment. This is because aluminum disrupts normal bone metabolism, leading to conditions such as osteomalacia (softening of the bones) and aluminum-associated bone disease. In patients undergoing dialysis, where the efficiency of toxin removal is compromised, exposure to aluminum can increase due to the use of contaminated water or aluminum-containing medications. As aluminum accumulates in the body, especially in those with decreased kidney function, it can interfere with calcium metabolism and hinder osteoblast activity, which is critical for bone formation. This highlights the importance of monitoring aluminum levels, particularly in populations at risk, including those receiving renal replacement therapies.