Serum Trace Elements in Children with End-Stage Renal Disease

Esmaeili, Mohammad; Rakhshanizadeh, Forough

doi:10.1053/j.jrn.2018.05.005

Cited by 16 publications

(19 citation statements)

References 31 publications

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“…The homeostasis of trace elements depends on both biliary excretion and optimal renal excretory function [ 1 ]. When normal excretory ability becomes inadequate as a result of chronic kidney disease (CKD), hemodialysis (HD) is one of the interventional treatment methods enabling the preservation of vital functions [ 2 ].…”

Section: Introductionmentioning

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: Introductionmentioning

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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“…Low serum metallothionein levels which were observed in this study may be due to the generation of the free radicals as the oxidative stress that played a role in the pathogenesis of chronic kidney disease (Ziedan and Bhandari, 2019). Moreover, certain serum trace elements were increased in chronic kidney disease and contributed to the generation of free radicals (Esmaeili and Rakhshanizadeh, 2019;Zeng et al, 2019). Therefore, low serum level of metallothionein and increased levels of circulating heavy metals or trace elements aggravate the nephrotoxicity (Zeng et al, 2019;Hao et al, 2015).…”

Section: Dicussionmentioning

confidence: 59%

“…Moreover, the serum levels of zinc and selenium were signi icantly reduced in children with chronic kidney disease (CKD) managed with hemodialysis compared with healthy children or patients not subjected to hemodialysis (Esmaeili and Rakhshanizadeh, 2019).…”

Section: Introductionmentioning

confidence: 99%

Recovery of serum metallothionein level after hemodialysis in patients with end stage renal failure

Saeed

Al-Hasani

Al-Nimer

2020

ijrps

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Metallothioneins (MTs) are intracellular metal-protein which not alone have inactivated heavy metals but also have traced elements while improving the antioxidant status. Serum levels of some heavy metals and trace elements showed toxic levels in the end-stage renal failure. This study is aimed to determine the serum level of metallothionein in patients with chronic kidney disease (CKD) and to show the effects of hemodialysis on its level. This cross-sectional study included 125 patients with CKD managed with regular hemodialysis. Estimated glomerular filtration rate (eGFR) was calculated by using the Cockroft and Gault equation adjusted to the body surface area (ml/min/m2), and 4 variable modified diet in renal disease (4-v MDRD) equation (ml/min/1.73m2). The mean ± SD of serum metallothionein was significantly less than the corresponding level of healthy subjects (1113.4±289.5 pg/ml versus 1536.0±341.4 pg/ml). Hemodialysis improves the serum level of metallothionein to attain 1437.6±406.1 pg/ml. There is a non-significant correlation between serum metallothionein with the eGFR and hemodialysis did not produce a significant effect on the correlation between serum metallothionein with eGFR. We conclude that serum metallothionein level is a useful prognostic marker for CKD and hemodialysis plays a role in the recovery of serum metallothionein level.

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“…The studies by Esmaeili and Rakhshanizadeh [9] and Esfahani et al [10] reported no significant difference between the serum zinc and copper concentrations between healthy children and those with CKD receiving conservative management. Esmaeili and Rakhshanizadeh [9] also noted no significant difference between serum concentrations of selenium between healthy children and those with CKD receiving conservative management. Youssef et al [11] reported that zinc and copper concentrations were significantly lower in children with CKD (stages 3 and 4) on conservative management, compared with healthy children.…”

Section: Discussionmentioning

confidence: 95%

Vitamin and trace element concentrations in infants and children with chronic kidney disease

et al. 2020

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Background There are limited data regarding vitamin and trace element blood concentrations and supplementation needs in children with non-dialysis stages 3-5 of chronic kidney disease (CKD). Methods Retrospective cross-sectional review for nutritional blood concentrations measured over a recent 2-year period. In our CKD clinics, nutritional bloods including copper, zinc, selenium and vitamin A, vitamin E, active vitamin B 12 and folate are monitored annually. Vitamin D status is monitored every 6-12 months. Results We reviewed 112 children (70 boys) with median (IQ1, IQ3) age 8.97 (4.24, 13.80) years. Estimated median (IQ1, IQ3) GFR (mL/min/1.73 m 2) was 28 (21, 37). Vitamin A, active vitamin B 12 and vitamin E concentrations were within normal range in 19%, 23% and 67% respectively, with all others being above normal range. Vitamin D blood concentrations were within desired range for 85% (15% had low levels) and folate blood concentrations were within normal range in 92%, with the remainder above or below target. For trace elements, 60%, 85% and 87% achieved normal ranges for zinc, selenium and copper respectively. Deficiencies were seen for zinc (35%), copper (7%), folate (3%) and selenium (1%), whilst 5%, 6% and 14% had zinc, copper and selenium levels above normal ranges. Conclusions Several vitamin and trace element blood concentrations were outside normal reference ranges. Monitoring vitamin D and zinc blood concentrations is indicated due to the percentages with low levels in this group. Targeted vitamin and trace element supplementation should be considered where indicated rather than commencing multivitamin and/or mineral supplementation.

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Serum Trace Elements in Children with End-Stage Renal Disease

Cited by 16 publications

References 31 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

Recovery of serum metallothionein level after hemodialysis in patients with end stage renal failure

Vitamin and trace element concentrations in infants and children with chronic kidney disease

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