Changes in Trace Elements During Early Stages of Chronic Kidney Disease in Type 2 Diabetic Patients

Abstract

Trace elements can influence glucose metabolism and be related to oxidative stress in type 2 diabetes mellitus. Moreover, trace elements play important roles in the nephrotic complications of these patients. Nevertheless, few investigations have been made into the changes in the levels of trace elements in diabetic patients at various stages of chronic kidney disease (CKD). The aims of this present study were to determine the levels of some important trace elements in diabetic patients during the early stages of CKD and to identify the relationship between these elements and CKD progression in type 2 diabetic patients. One hundred and forty-eight type 2 diabetic patients with chronic kidney diseases were recruited into this study. The subjects were grouped into four stages (1, 2, 3a, 3b) of CKD, according to their urine protein levels and estimated glomerular filtration rates (eGFRs). The levels of serum zinc and iron exhibited a statistically significant decreasing trend (P trend = 0.032 and 0.047, respectively) from stage 1 to stage 3b after adjustment for age, gender, smoking, alcohol consumption, education, hypertension, and body mass index. The other tested elements, including copper, magnesium, selenium, chromium, and manganese, did not display any significant trends upon proceeding from stage 1 to stage 3b. Thus, serum zinc and iron appear to be useful markers when evaluating the early progression of CKD in type 2 diabetic patients.

Micronutrients and Renal Outcomes: A Prospective Cohort Study

“…Conversely, excess amounts put individuals at risk of metabolic disorders [ 6 , 7 , 8 ]. Several mechanisms may contribute to micronutrient deficiency in the milieu of chronic kidney disease (CKD), including leaching by dialysis, decreased intestinal absorption, altered gut microbiota, and uremic anorexia [ 9 ]. Serum Zn and Se levels in dialysis patients have been widely investigated because of their prevalent deficiency, ubiquitous biological roles in physiological function, and potential for antioxidation.…”

Plasma Levels and Dietary Intake of Minerals in Patients with Type 2 Diabetes and Chronic Kidney Disease

“…In this study, the plasma status of minerals was precisely assessed using the HR-ICP-MS among the subjects with T2D, with and without kidney disease, and healthy controls. Given that the dietary intake of minerals is a modi able factor to address the prevention of nutritional de ciencies in CKD [32], we recorded the dietary intakes using RFFQ. The usage of HR-ICP-MS combined with a small-size sample (0.15 mL) preparation was validated and applied for the determination of plasma levels of selected minerals: one macro element and eight trace elements.…”

Iron homeostasis, recycling and vulnerability in the stressed kidney: A neglected dimension of iron‐deficient heart failure

“…[32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] In biopsies taken from patients with chronic kidney disease, iron influx transporters in the renal tubules are markedly upregulated, iron efflux transporters are down-regulated, and iron accumulates in the lysosomes of proximal renal tubular cells, 4,47 while the urinary excretion of unbound iron declines as chronic kidney disease progresses. 48 High serum levels of malondialdehyde (reflecting lipid peroxidation) and low blood levels of GPX4 (an antagonist of ferroptosis) have prognostic significance in patients with declining glomerular function. [49][50][51][52] Enhanced transferrin-mediated entry of iron places proximal tubular cells at risk.…”