Benefits and risks of essential trace elements in chronic kidney disease: a narrative review

Xie, Yi; Liu, Fei; Zhang, Xiaojing; Ye, Jin; Li, Qiuyu; Shen, Huijun; Fu, Haidong; Mao, Jianhua

doi:10.21037/atm-22-5969

Cited by 15 publications

(7 citation statements)

References 232 publications

(265 reference statements)

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“…(2020), Mn contributes to the development of glomerular disease. However, the observed increase in circulating Mn levels may be due to the gradual aggravation of chronic renal failure with time (Xie et al, 2022). The results from the present study are supportive of a protective effect by Mn against CKDu, within the observed range of concentrations.…”

Section: Data Synthesissupporting

confidence: 80%

Chemical Distinctions of Groundwater Consumed by Communities Affected by Chronic Kidney Disease of Unknown Etiology in Northcentral Sri Lanka: Implications for Multiple Contributory and Inhibitory Ions

Prame,

Siriwardana,

Hettiarachchi

et al. 2024

Preprint

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Long-term exposure to contaminated drinking water from shallow dug wells is widely suspected to be the cause of chronic kidney disease of unknown etiology (CKDu) which prevails in northcentral Sri Lanka. Although several hydrogeochemical studies have been conducted in this area, studies that have attempted robust statistical comparisons between waters consumed by CKDu-affected and CKDu-free communities within the endemic area are rare, and the causative agents of the disease remain elusive. We attempted to determine the hydrochemical differences between the groundwater consumed by CKDu-affected communities and that consumed by CKDu-unaffected communities living in the CKDu-endemic area based on a substantial new dataset that ensures the robustness of the statistical and graphical comparisons. The study revealed that SO42−, PO43−, NO3−, Sr, Mg, Ba, Pb, and Cu were significantly greater in CKDu-linked water and were positively correlated with the incidence of CKDu, indicating their causative role. Manganese and Zn levels were significantly lower in CKDu-linked water and were negatively correlated with CKDu-incidence, indicating an impeding effect. Our results agree with the elevated hardness and F− values reported in previous work. However, statistical and graphical comparisons do not support the widely speculated role of F− in the incidence of CKDu. Toxic metals and metalloids except for V occur at concentrations accepted as safe for human consumption. Subtle but significant contributions from several chemical constituents occurring in concentrations accepted to be safe and permissible could be interpreted as supporting evidence for the participatory role of multiple ions, probably imposing a deleterious synergistic effect.

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Section: Data Synthesissupporting

confidence: 80%

Chemical Distinctions of Groundwater Consumed by Communities Affected by Chronic Kidney Disease of Unknown Etiology in Northcentral Sri Lanka: Implications for Multiple Contributory and Inhibitory Ions

Prame,

Siriwardana,

Hettiarachchi

et al. 2024

Preprint

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“…This risk is compounded by heightened hepcidin production, which can hasten iron absorption. Furthermore, the chronic inflammatory state characteristic of CKD may further disrupt iron metabolism, exacerbating the potential for complications [151]. The interplay between iron supplementation, altered iron metabolism and the inflammatory state in CKD can create a complex scenario where microbial proliferation and susceptibility to infections may be heightened.…”

Section: Iron (Fe)mentioning

confidence: 99%

“…Copper (Cu) is the body's third most abundant trace element [151]. Copper is an important enzymatic cofactor for energy production and iron absorption.…”

Section: Copper (Cu)mentioning

confidence: 99%

“…The DRIs for manganese are 0.003-0.6 mg/day for infants and 1.2-1.5 mg/day for children [139] (Figure 4). Manganese is present in a wide variety of foods, including whole grains, clams, oysters, mussels, nuts, soybeans and other legumes, rice, leafy greens, coffee, tea and many spices such as black pepper [151,218]. The intestinal absorption of manganese is very poor (maximum 10%) and undergoes competition from iron and cobalt.…”

Section: Manganese (Mn)mentioning

confidence: 99%

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Role of Nutrients in Pediatric Non-Dialysis Chronic Kidney Disease: From Pathogenesis to Correct Supplementation

Padoan,

Guarnaroli,

Brugnara

et al. 2024

Biomedicines

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Nutrition management is fundamental for children with chronic kidney disease (CKD). Fluid balance and low-protein and low-sodium diets are the more stressed fields from a nutritional point of view. At the same time, the role of micronutrients is often underestimated. Starting from the causes that could lead to potential micronutrient deficiencies in these patients, this review considers all micronutrients that could be administered in CKD to improve the prognosis of this disease.

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“…However, patients undergoing HD have been reported to have a higher mortality rate than the general population did [1]. Iron is an essential element in most human cells and a cofactor for vital proteins and enzymes [2]. Iron dysregulation is common in patients undergoing HD.…”

Section: Introductionmentioning

confidence: 99%

Association between Iron Status and Survival in Patients on Chronic Hemodialysis

et al. 2023

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The aim of this study was to evaluate survival rates according to iron status in patients undergoing maintenance hemodialysis (HD). Thus, the National HD Quality Assessment Program dataset and claims data were used for analysis (n = 42,390). The patients were divided into four groups according to their transferrin saturation rate and serum ferritin levels: Group 1 (n = 34,539, normal iron status); Group 2 (n = 4476, absolute iron deficiency); Group 3 (n = 1719, functional iron deficiency); Group 4 (n = 1656, high iron status). Using univariate and multivariable analyses, Group 1 outperformed the three other groups in terms of patient survival. Using univariate analysis, although Group 2 showed a favorable trend in patient survival rates compared with Groups 3 and 4, the statistical significance was weak. Group 3 exhibited similar patient survival rates to Group 4. Using multivariable Cox regression analysis, Group 2 had similar patient survival rates to Group 3. Subgroup analyses according to sex, diabetic status, hemoglobin level ≥ 10 g/dL, and serum albumin levels ≥ 3.5 g/dL indicated similar trends to those of the total cohort. However, subgroup analysis based on patients with a hemoglobin level < 10 g/dL or serum albumin levels < 3.5 g/dL showed a weak statistical significant difference compared with those with hemoglobin level ≥ 10 g/dL, or serum albumin levels ≥ 3.5 g/dL. In addition, the survival difference between Group 4 and other groups was greater in old patients than in young ones. Patients with a normal iron status had the highest survival rates. Patient survival rates were similar or differed only modestly among the groups with abnormal iron status. In addition, most subgroup analyses revealed similar trends to those according to the total cohort. However, subgroup analyses based on age, hemoglobin, or serum albumin levels showed different trends.

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Benefits and risks of essential trace elements in chronic kidney disease: a narrative review

Cited by 15 publications

References 232 publications

Chemical Distinctions of Groundwater Consumed by Communities Affected by Chronic Kidney Disease of Unknown Etiology in Northcentral Sri Lanka: Implications for Multiple Contributory and Inhibitory Ions

Chemical Distinctions of Groundwater Consumed by Communities Affected by Chronic Kidney Disease of Unknown Etiology in Northcentral Sri Lanka: Implications for Multiple Contributory and Inhibitory Ions

Role of Nutrients in Pediatric Non-Dialysis Chronic Kidney Disease: From Pathogenesis to Correct Supplementation

Association between Iron Status and Survival in Patients on Chronic Hemodialysis

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