Association between Serum Zinc Levels and Clinical Index or the Body Composition in Incident Hemodialysis Patients

Toida, Tatsunori; Toida, Reiko; Ebihara, Shou; Takahashi, Rena; Komatsu, Hiroyuki; Uezono, Shigehiro; Sato, Yuji; Fujimoto, Shouichi

doi:10.3390/nu12103187

Cited by 10 publications

(8 citation statements)

References 41 publications

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“…As an antioxidant and anti-inflammatory mediator, Zn regulates the function of T- and B-lymphocytes, making the body’s immune system less susceptible to various infections [ 13 ]. Recently, the protective role of Zn in HD patients with COVID-19 has been mentioned [ 14 ]. Since it has been noted that Zn deficiency could increase oxidative stress and atherosclerotic complications, particularly in patients in late-stage renal failure, a practical response would be to start timely Zn supplementation at the moment when patients require initial HD treatment.…”

Section: Discussionmentioning

confidence: 99%

Circulatory Imbalance of Essential and Toxic Trace Elements in Pre-dialysis and Hemodialysis Patients

Stojsavljević

Ristić‐Medić

Krstić

et al. 2021

Biol Trace Elem Res

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The status of essential and toxic trace elements in patients with different stages of chronic kidney disease (CKD) is still unclear and not well characterized. The present study examined the circulatory levels of a wide panel of trace elements (Al, Cr, Mn, Co, Ni, Cu, Zn, As, Se, Rb, Sr, Cd, Pb, and U) in hemodialysis patients (HD group) and pre-dialysis patients with stage 3 CKD (PD group). Comparisons were made between groups of patients and healthy individuals from the control group (CG). The levels of Al, Mn, Co, Ni, Cu, As, Se, Sr, and Pb were higher, while the levels of Cr, Zn, Rb, Cd, and U were lower in HD patients than in our CG. Higher levels of Al and Se, as well as lower levels of As, Sr, Zn, Rb, and U were significant and distinguished HD from PD. Among other analyzed elements, Co, Se, and U are the only trace elements that did not distinguish PD from CG at a statistically significant level. The HD group had lower serum U levels than the PD group, and this could be a result of hemodialysis. This study also revealed that the Cu/Zn ratio could be used as a marker for early and late detection of renal failure. Marked changes of essential and toxic trace element levels in sera indicate additional pathophysiological events in CKD, which could additionally contribute to the preexisting increased morbidity of HD patients. Measurement of trace elements in HD patients should be performed routinely. Supplementary Information The online version contains supplementary material available at 10.1007/s12011-021-02940-7.

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Section: Discussionmentioning

confidence: 99%

Circulatory Imbalance of Essential and Toxic Trace Elements in Pre-dialysis and Hemodialysis Patients

Stojsavljević

Ristić‐Medić

Krstić

et al. 2021

Biol Trace Elem Res

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“…Only a few studies of hemodialysis patients have been conducted. Recently, Toda et al prospectively investigated the association of zinc status and CVD events in 142 incident hemodialysis patients [ 141 ]. Although all patients undergoing hemodialysis are at risk for a CVD event, this longitudinal study (mean follow-up 2.5 years, 20 cases with CVD events) showed an insignificant association of a lower zinc level with a higher risk of CVD.…”

Section: Zinc Levels and Cvd Eventsmentioning

confidence: 99%

Association of Zinc Deficiency with Development of CVD Events in Patients with CKD

et al. 2021

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Deficiency of the micronutrient zinc is common in patients with chronic kidney disease (CKD). The aim of this review is to summarize evidence presented in literature for consolidation of current knowledge regarding zinc status in CKD patients, including those undergoing hemodialysis. Zinc deficiency is known to be associated with various risk factors for cardiovascular disease (CVD), such as increased blood pressure, dyslipidemia, type 2 diabetes mellitus, inflammation, and oxidative stress. Zinc may protect against phosphate-induced arterial calcification by suppressing activation of nuclear factor kappa light chain enhancer of activated B. Serum zinc levels have been shown to be positively correlated with T50 (shorter T50 indicates higher calcification propensity) in patients with type 2 diabetes mellitus as well as those with CKD. Additionally, higher intake of dietary zinc was associated with a lower risk of severe abdominal aortic calcification. In hemodialysis patients, the beneficial effects of zinc supplementation in relation to serum zinc and oxidative stress levels was demonstrated in a meta-analysis of 15 randomized controlled trials. Thus, evidence presented supports important roles of zinc regarding antioxidative stress and suppression of calcification and indicates that zinc intake/supplementation may help to ameliorate CVD risk factors in CKD patients.

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“…Recent evidence has suggested several plausible explanations for the link between lower serum zinc levels and diastolic dysfunction. First, serum zinc levels have been associated with fluid volume and nutritional status in HD patients [ 33 ]. Taste changes are common and associated with malnutrition in maintenance dialysis patients [ 34 ], and they may result in decreased intake of calories and zinc-rich foods.…”

Section: Discussionmentioning

confidence: 99%

Association between Reduced Serum Zinc and Diastolic Dysfunction in Maintenance Hemodialysis Patients

Huang

et al. 2021

Nutrients

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Diastolic dysfunction is an emerging challenge among hemodialysis (HD) patients, and the associations between serum zinc with echocardiographic parameters and diastolic function remain uncertain. A total of 185 maintenance HD patients were stratified by the tertiles of serum zinc level to compare their clinical characteristics and echocardiography. Correlations of serum zinc levels with echocardiographic parameters were examined using Pearson’s analysis. Univariate and multivariate logistic regression analyses were performed to investigate the determinants of E/e’ ratio >15 and left atrial volume index (LAVI) > 34 mL/m2, both indicators of diastolic dysfunction. Patients belonging to the first tertile of serum zinc level had a significantly higher E/e’ ratio and LAVI. Serum zinc levels were negatively correlated with E (r = −0.204, p = 0.005), E/e’ ratio (r = −0.217, p = 0.003), and LAVI (r = −0.197, p = 0.007). In a multivariate analysis, older age, diabetes, coronary artery disease, and lower serum zinc levels (OR = 0.974, 95% CI = 0.950–0.999, p = 0.039) were significantly associated with E/e’ ratio >15. Furthermore, diabetes and lower serum zinc levels (OR = 0.978, 95% CI = 0.958–0.999, p = 0.041) were significantly associated with LAVI >34 mL/m2. Reduced serum zinc level was significantly associated with diastolic dysfunction among HD patients. Further prospective studies are warranted to investigate whether zinc supplementation can attenuate cardiac dysfunction in maintenance HD patients.

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Association between Serum Zinc Levels and Clinical Index or the Body Composition in Incident Hemodialysis Patients

Cited by 10 publications

References 41 publications

Circulatory Imbalance of Essential and Toxic Trace Elements in Pre-dialysis and Hemodialysis Patients

Circulatory Imbalance of Essential and Toxic Trace Elements in Pre-dialysis and Hemodialysis Patients

Association of Zinc Deficiency with Development of CVD Events in Patients with CKD

Association between Reduced Serum Zinc and Diastolic Dysfunction in Maintenance Hemodialysis Patients

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