Long-Term Changes of Plasma Trace Element Concentrations in Chronic Hemodialysis Patients

Abstract

Background: Hemodialysis (HD) patients are at risk of developing trace element imbalances. Methods: The 12 trace elements Cd, Co, Cs, Cu, La, Mg, Mo, Pb, Rb, Sr, Tl and Zn were determined in the plasma (n = 52) of 6 chronic HD patients before and after HD sessions by inductively coupled plasma mass spectrometry. Plasma trace element concentrations were monitored for 6 months. Baseline data have been compared to the concentrations at the end of the observation period to identify a potential reduction or accumulation of trace elements in HD patients. Results: Plasma Cd, Co and Pb levels were about 10 times higher than in healthy adults. Concentrations of Co and Pb increased during HD sessions, whereas plasma Co and Cd increased during the study period of 6 months. Plasma Cs, Mg, Mo and Rb continuously decreased in all patients. For plasma Cu and Zn, a statistically significant rise of their plasma concentrations during HD and during the period of 6 months could be established. Concentrations of La and Tl did not change distinctly. Conclusion: This study revealed that plasma trace element concentrations in HD patients are distinctly different compared to that of healthy adults. Elements such as Cs, Mg, Mo and Rb are reduced and Cd, Co and Pb are accumulated in HD patients. Further studies are needed to elucidate the clinical impact of these trace element imbalances.

Effects of hemodialysis period on levels of blood trace elements and oxidative stress

“…They found Zn amounts in HD patients lower than those in control groups [3]. Krachler et al [2] found elemental composition changes in plasma and observed a decrease in Mg levels over a 6-month period. In our study, plasma Zn, Cu, and Mg trace element levels of CRF patients, classified according to their HD periods, were compared with a control group.…”

“…Patients with chronic renal failure requiring hemodialysis (HD) are at risk of developing severe trace element imbalances. Medication, the uremic state, the dialysis process, and the quality of water used for dialysis may contribute to such clinical abnormalities in dialyzed uremic patients [2]. Although recent improvement in the dialysis technique prevents some serious complications by changes in trace elements, problems still remained [3].…”

Comparative Study on Trace Element Excretions between Nonanuric and Anuric Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

“…The positive effects of these element supplements on CKD patients are also supported by some research studies [19,20]. The majority of the studies that evaluated the status of these TEs focused on CKD patients without dialysis treatment and those receiving hemodialysis (HD), while limited investigations have been conducted regarding CAPD patients [9,21,22,23,24,25,26]. In addition, few studies have been reported on the status of TE excretions in CAPD patients under the special circumstance of this disease, which would provide suggestions for clinical prevention and treatment and would even be available to establish recommendations for supplementation of deficient TEs.…”

Rubidium, Salami and Depression

“…The discussion concerning the role of rubidium as an antidepressant has recently been reopened because a deficiency has been discovered in uremic patients undergoing dialysis treatment [18][19][20][21][22][23][24][25][26][27][28][29][30] . Research is being carried out to discover if this deficiency is due to dialysis or a low rubidium intake in the diet.…”