Trace Elements in Hemodialysis and Continuous Ambulatory Peritoneal Dialysis Patients

Abstract

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.

Impact of Hemodialysis on Serum Zinc and Copper Level in CKD Patients

“…Mean zinc levels among pre and post hemodialysis samples Mean urea and creatinine level in pre and post hemodialysis samples Hemodialysis treatment for patients with CKD may lead to increase or depletion of biologically function substances like trace elements thus hemodialysis patients are at theoretical risk for both deficiency and accumulation of these elements, depending on dialysis impact, composition of the source water used for hemodialysis, and residual kidney function (D'Haese et al, 1996;Zima et al, 1998). Thus could impact positive or negative on trace elements metabolism and functions.…”

“…The radiation measured by using detector and the absorbance was converted to analyte concentration (Zima et al, 1999). Brief according to the manufacture ' s protocol, serum zinc and copper were diluted 1:5 and 1:1 with deionized, then diluted serum aspirated and absorbance was measured at wave length 213.9 nm and 324.8 nm respectively.…”

Blood Arsenic and Cadmium Concentrations in End-Stage Renal Disease Patients who were on Maintenance Haemodialysis

“…The group B subjects were further grouped, based on the duration of their MHD. Group C was ESRD patients who were on MHD for 6 to 12 months; Group D was ESRD patients who were on MHD for dISCuSSIOn Deficiencies of the essential trace elements (such as zinc, copper and selenium) and excesses of the potentially harmful toxic elements (such as lead, arsenic, cadmium) are both known to cause adverse consequences in the general population [6][7][8][9]. The end-stage renal disease patients have a mortality risk which is several times higher than their counterparts who do not have any significant renal disease.…”

Serum zinc and hormonal profile in male dialysis patients receiving human recombinant erythropoietin

“…Moreover, only a small part of the total body zinc content is in the blood, and serum zinc may not reflect the exact amount of zinc stores in uremic patients submitted to chronic dialysis. A difference in concentrations of this trace element between plasma, erythrocytes, and whole blood was observed (36) . Despite that, serum zinc may be considered a marker of nutritional status in dialysis patients and it was positively correlated with pre-albumin, a useful marker of nutritional status (7) .…”