Trace Elements in End-Stage Renal Disease

Abstract

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.

Tc-99m TRODAT-1 SPECT is a Potential Biomarker for Restless Leg Syndrome in Patients with End-Stage Renal Disease

“…Dysregulated metabolism of trace elements is common in patients with ESRD [36]. In patients with CKD, the elimination of ingested elementary heavy metals would be less owing to impaired glomerular filtration and the dialysate might move or retain trace elements within the body [37]. In our study, the urinary copper concentration was higher in patients with RLS than in the control group, which is concordant with the findings of the systemic review conducted by Tonelli et al [36].…”

Disturbances of trace element metabolism in ESRD patients receiving hemodialysis and hemodiafiltration

“…Solution that is prepared by a hemodiafiltration machine (hemodiafiltration online) can also be used during the procedure [3]. Thus, hemodialysis patients are at theoretical risk for both deficiency and accumulation of trace elements, depending on dietary intake, removal by dialysis, the composition of the source water used for hemodialysis and residual kidney function [4, 5]. …”

Serum Level of Trace Elements in Pediatric Patients with End Stage Renal Disease on Hemodialysis

“…This energy absorption is specific to particular electron transitions in each element. The radiation was measured using a detector, and the absorbance was converted to analyte concentration according to the manufacturer's protocol [11] .…”