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

Abstract

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.

Zinc Ameliorates the Osteogenic Effects of High Glucose in Vascular Smooth Muscle Cells

“…Zinc has emerged as a putative protective factor in cardiovascular calcification, and low dietary zinc intake has been linked to calcification in the general population [21,23,45]. In patients with chronic kidney disease, zinc deficiency is associated with the development of cardiovascular disease [46]. The current study extends these findings by showing that zinc deficiency may contribute to vascular calcification during hyperglycemic conditions.…”

Zinc Deficiency, Plasma Fatty Acid Profile and Desaturase Activities in Hemodialysis Patients: Is Supplementation Necessary?

“…This biomarker, used also for the evaluation of oxidative stress burden, is associated with a higher risk of incident infection (10) and elevated cardiovascular mortality rate in the elderly population (12)(13)(14). Zinc, as an antioxidant and antiinflammatory mediator, regulates the function of lymphocytes, making the body's immune system less susceptible to various infections (15)(16)(17). Recently, the protective role of zinc in vulnerable groups for COVID-19 such as hemodialysis patients has been mentioned (18).…”

Impaired ion homeostasis as a possible associate factor in mucopolysaccharidosis pathogenesis: transcriptomic, cellular and animal studies

“…For example, data showing both a decrease and an increase in the level of metal ions were observed in the case of Alzheimer’s disease depending on the selected model, tissue or experimental set-up (Wang et al 2020 ). So far, observations of reduced levels of metal ions have been reported in the case of chronic kidney disease, in which the decrease in Zn 2+ concentration was correlated with growth disturbance, taste impairment, anorexia and loss of appetite, dermatitis, delayed wound healing, and infection (Nakatani et al 2021 ). Moreover, lowered Ca 2+ levels corelate with skeletal and cardiovascular disorders, muscle aches, hypertension, periodontal disease, or diabetes mellitus (Peterlik et al 2009 ).…”