Zinc Absorption in Haemodialysis Patients

Foote, John; Hinks, Lesley J.

doi:10.1177/000456328802500413

Cited by 23 publications

(10 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Zinc deficiency may be common in chronic diseases such as malnutrition, diarrhea, malabsorption syndromes, inflammatory bowel disease, alcoholic cirrhosis, and sickle cell disease. In chronic kidney disease, a number of mechanisms may contribute to zinc deficiency including leaching by dialysis (12) and decreased intestinal absorption (13). Approximately 45 percent of healthy adults may have inadequate zinc intakes (14).…”

Section: Zincmentioning

confidence: 99%

Trace Element Status in Hemodialysis Patients

Rucker

Thadhani

Tonelli

2010

Seminars in Dialysis

View full text Add to dashboard Cite

Patients with chronic kidney disease undergoing hemodialysis (HD) are potentially at risk of deficiency and excess of trace elements. HD exposes patients to large volumes of water (>120 l/week) in the form of dialysate. Although levels of certain ions (such as potassium and calcium) are carefully regulated in dialysate, many others are measured infrequently, if ever. As a result, substances in lower concentrations in the dialysis may be leached from the body. Conversely, toxic trace elements present in water but not in blood may accumulate and cause toxicity. Given that essential trace elements play key roles in multiple biological systems including immunological defense against oxidation and infection, it has been hypothesized that the increased morbidity and mortality seen in HD patients may in part be due to the imbalance of trace elements that has not been recognized. A recent systematic review has shown that compared with healthy controls, HD patients have significantly lower blood levels of zinc, manganese, and selenium, while blood levels of lead are likely to accumulate. Other trace elements, such as mercury and arsenic, are biologically plausible causes of excess mortality in dialysis patients, but available evidence is inconclusive as to whether they consistently accumulate in this population. Whether altered trace element levels are potentially reversible causes of adverse clinical outcomes in dialysis patients remains to be determined. This review highlights key issues related to this hypothesis, with special emphasis on zinc, manganese, selenium, lead, mercury, and arsenic.

show abstract

Section: Zincmentioning

confidence: 99%

Trace Element Status in Hemodialysis Patients

Rucker

Thadhani

Tonelli

2010

Seminars in Dialysis

View full text Add to dashboard Cite

show abstract

“…Serum Zn levels were significantly lower in subjects with severe renal failure [8] than in subjects with mild renal failure [26]. This may be related to impaired intestinal Zn absorption [27] and reduced affinity of Zn to albumin in uremic subjects [27,28].…”

Section: Zincmentioning

confidence: 99%

“…HD has probably little or no effect on the serum Zn levels [9,36,37]. Depending on the type of dialyzer, Zn may, however, be lost during HD [27]. On the other hand, release of considerable amounts of Zn from Zn plasters used in the construction of some coil dialyzers was demonstrated in dialyzed patients [38], and should be excluded before recommending Zn supplementation in these subjects.…”

Section: Zincmentioning

confidence: 99%

Trace Elements in End-Stage Renal Disease

Zima¹,

Tesař²,

Mestek

et al. 1999

Blood Purif

View full text Add to dashboard Cite

For human beings trace elements are essential nutrients with a gamut of functions. They are for instance indispensable components of many enzymes, so they have some regulatory functions and they may affect immune reactions and free radical generation. Abnormalities of trace elements are primarily the result of uremia, and they may be further modified and sometimes greatly exacerbated by the dialysis procedure. The role of trace elements in hemodialysis (HD) patients has not yet been fully characterized. To prevent some complications in chronic HD patients, it is very important to regulate the levels of trace elements by adequate water treatment. Reverse osmosis is able to prevent the accumulation of the majority of trace elements in the patients. Zinc supplementation may be recommended for patients with proven zinc deficiency, but for all chronic renal failure patients it is questionable. Selenium deficiency is to be suspected in dialyzed patients and selenium supplementation may be beneficial (increasing glutathione peroxidase activity, cardioprotective effect, immunostimulatory properties) for chronic renal failure patients. Supplementation with a trace element may be indicated when its depletion was unequivocally documented and when there is evidence of the positive effects of this element on the quality of life of the dialyzed patients.

show abstract

“…The frequently observed low plasma Zn level is connected with Zn loss during HD, the type of dialyzer used, and perhaps with disturbances in the gastrointestinal tract, which may also be responsible for the decreased plasma Zn level in HD patients [22]. High erythrocyte Zn in the presence of low plasma Zn may be related to factors other than dialysis.…”

Section: Discussionmentioning

confidence: 99%

Trace Elements in Hemodialysis and Continuous Ambulatory Peritoneal Dialysis Patients

Zima¹,

Mestek

Němeček

et al. 1998

Blood Purif

View full text Add to dashboard Cite

Alterations in blood and tissue concentrations of trace elements in patients with chronic renal failure have been extensively investigated. Selenium, zinc and copper are elements which play an important role in biological systems as components of proteins, enzymes and antioxidants. The concentrations of selenium, zinc and copper were determined in the plasma, erythrocytes and whole blood of patients on regular hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) treatment using the method of inductively coupled plasma mass spectrometry (ICP-MS). Analysis of isotopes ⁷⁷Se, ⁶⁶Zn and ⁶⁵Cu was performed. Methodology presents the major limitation to valid studies on trace element levels in biological materials. One of the widely used contemporary techniques is ICP-MS. It is the most sensitive one and has a high dynamic range. The selenium concentration in the studied compartments (plasma 46.1 ± 3.0 vs. 78.0 ± 3.4 μg/l, p < 0.001; erythrocytes 90.4 ± 6.5 vs. 134.2 ± 7.6 μg/l, p < 0.01; whole blood 67.3 ± 3.1 vs. 106.4 ± 3.4 μg/l, p < 0.001) was significantly lower in HD patients compared to healthy controls. The same result was observed in plasma (63.2 ± 5.8 vs. 78.0 ± 3.4 μg/l, p < 0.05) and whole blood (82.7 ± 7.4 vs. 106.4 ± 3.4 μg/l, p < 0.01) from CAPD patients, but the selenium level of erythrocytes in CAPD patients was the same as in the control group (126.0 ± 8.8 vs. 134.2 ± 7.6 μg/l). The cooper content of erythrocytes was lower in HD patients than in controls (0.55 ± 0.02 vs. 0.66 ± 0.01 mg/l, p < 0.01) and CAPD groups (0.55 ± 0.02 vs. 0.68 ± 0.02 mg/l, p < 0.001). There were no differences in copper content in plasma (HD 1.02 ± 0.06; CAPD 1.11 ± 0.09; controls 1.02 ± 0.05 mg/l) and whole blood (HD 0.87 ± 0.04; CAPD 0.90 ± 0.05; controls 0.85 ± 0.02 mg/l) in HD and CAPD patients and healthy controls. The zinc concentration was increased in the whole blood of CAPD patients (6.68 ± 0.36 vs. 5.52 ± 0.11 mg/l, p < 0.001) and erythrocytes of HD (12.30 ± 0.23 vs. 10.11 ± 0.42 mg/l, p < 0.001), and CAPD groups (13.71 ± 0.56 vs. 10.11 ± 0.42 mg/l, p < 0.001) compared to controls. However, the plasma zinc concentration was lower in HD patients compared to blood donors (0.69 ± 0.03 vs. 0.92 ± 0.03 mg/l, p < 0.001) and CAPD patients (0.69 ± 0.03 vs. 0.95 ± 0.04 mg/l, p < 0.001). We did not find a significant increase in trace elements in whole blood after HD. These results suggest differences between plasma, erythrocytes and whole blood concentrations of the studied trace elements. The levels of trace elements are altered by HD and CAPD. A modern precise method with high accuracy, ICP-MS, which was used in our study, eliminated analytical errors and possible interferences.

show abstract

Zinc Absorption in Haemodialysis Patients

Cited by 23 publications

References 12 publications

Trace Element Status in Hemodialysis Patients

Trace Element Status in Hemodialysis Patients

Trace Elements in End-Stage Renal Disease

Trace Elements in Hemodialysis and Continuous Ambulatory Peritoneal Dialysis Patients

Contact Info

Product

Resources

About