Open Journal Systems

Cover Image

Evaluation of Selected Trace Elements in Chronic Hemodialysis Patients in Nnamdi Azikiwe University Teaching Hospital, Nnewi Southeastern Nigeria.

Joy Nkiruka Ezeonyebuchi, Samuel Chukwuemeka Meludu, Chudi Emmanuel Dioka, Christian Ejike Onah, Okwudili Josiah Nnadozie, Angus Nnamdi Oli

Abstract


Background: Haemodialysis is the most common form of treatment for end stage renal disease (ESRD), and is associated with considerable morbidity and mortality which might be as a result of imbalance in essential minerals. Objective: This study is aimed at determining the levels of some trace elements (zinc, copper, selenium and cobalt) in chronic haemodialysis patients before dialysis, immediately after dialysis and one hour after dialysis. Methods: A total of 100 participants were used for this study. This includes fifty chronic haemodialysis subjects and 50 aged matched apparently normal subjects. The trace elements were assayed by atomic absorption spectrophotometric method. Results: The mean levels of Zn and Se were significantly lower in dialysis subjects 79.33(16.27) µg/dl, P=0.02 and 6.67(1.43)µg/dl, P<0.001 compared with the control 88.97(9.77)µg/dl and 9.00(2.48)µg/dl respectively. Cu showed a significantly high mean value in the dialysis 117.54(14.69) µg/dl, P=0.01 when compared with the control subjects 108.50(15.49)µg/dl. There was no significant difference in the mean level of Co 0.03(0.01)µg/dl, P=0.26 when compared with the control 0.04(0.00). Comparison of the mean levels of these minerals between male and female counterparts among the dialysis and control groups showed no significant differences. Conclusion: This study showed a marked reduction in zinc and selenium levels, and increased copper levels in haemodialysis patients than in controls. This shows an alteration in trace elements levels in chronic hemodialysis patients. 


Keywords


Trace elements, haemodialysis, infection, supplementation, oxidative stress.

Full Text:

PDF Remote

References


Tonelli M, Wiebe N, Hemmelgarn B, Klarenbach S, Field C, Manns B et al. Trace elements in hemodialysis patients: a systematic review and meta-analysis. BMC Medicine 2009;7:25.

http://dx.doi.org/10.1186/1741-7015-7-25

PMid:19454005 PMCid:PMC2698829

Al Wakeel JS, Mitwalli AH, Al Mohaya S, Abu-Aisha H, Tarif N, Malik GH et al. Morbidity and mortality in ESRD patients on dialysis. Saudi J Kidney Dis Transpl 2002;13:473–7.

PMid:17660670

Fortes PC, Versari PH, Stinghen AE, Pecoits-Filho R. Controlling inflammation in peritoneal dialysis: the role of PD-related factors as potential intervention targets. Perit Dial Int 2007;27:S76–81.

PMid:17556335

Rambod M, Kovesdy CP, Kalantar-Zadeh K. Malnutrition-inflammation score for risk stratification of patients with CKD: is it the promised gold standard? Nat Clin Pract Nephrol 2008;4:354–5.

http://dx.doi.org/10.1038/ncpneph0834

PMid:18523431

Dounousi E, Papavasiliou E, Makedou A, Ioannou K, Katopodis KP, Tselepis A et al. Oxidative stress is progressively enhanced with advancing stages of CKD. Am J Kidney Dis 2006;48:752–60.

http://dx.doi.org/10.1053/j.ajkd.2006.08.015

PMid:17059994

Tetiker T, Paydas S, Yuregir G, Sagliker Y. Trace elements alterations in chronic hemodialysis patients with chronic renal failure and proteinuria. MJIAS 1993;6:33-5.

Vanholder R, Cornelis R, Dhondt A, Lameire N. The role of trace elements in uraemic toxicity. Nephrol Dial Transplant 2002;17:2-8.

http://dx.doi.org/10.1093/ndt/17.suppl_2.2

PMid:11904350

Maggini S, Wintergerst ES, Beveridge S, Hornig DH. Selected vitamins and trace elements support immune function by strengthening epithelial barriers and cellular and humoral immune responses. Br J Nutr 2007;98:S29–35.

http://dx.doi.org/10.1017/S0007114507832971

PMid:17922955

Rayman MP. The importance of selenium to human health. Lancet 2000;356:233–24

http://dx.doi.org/10.1016/S0140-6736(00)02490-9

Arthur JR, McKenzie RC, Beckett GT. Selenium in the immune response. J Nutr 2003;133:1457-9.

O'Dell BL. Role of Zinc in plasma membrane function. J Nutr 2000;130:1432-6.

Miura Y, Nakai K, Suwabe A, Sera K. Trace elements in renal disease and hemodialysis. Nucl Inst & Meth in Phys Res. 2002;189:443-449.

http://dx.doi.org/10.1016/S0168-583X(01)01122-3

Krachler M, Wirnsberger GH. Long-term changes of plasma trace element concentrations in chronic hemodialysis patients. Blood Purif 2000;18:138-43.

http://dx.doi.org/10.1159/000014437

Miura Y, Nakai K, Sera K, Sato M. Trace elements in sera from patients with renal disease. Nucl Inst & Meth in Phys Res 1999;150:18-21.

Michael LB, Edward PF, Larry ES. Clinical Chemistry: Principle, Procedure, Correlations. 5th edition. Philadelphia:Lippincott Williams and Wilkins; 2005. p. 153-6.

Anees M, Mumtaz A, Frooql S, Ibrahim M, Hameed F. Serum trace elements (Aluminium, Copper, Zinc) in hemodialysis patients. Biomedica 2011;27:106-10.

Dashti-Khavidaki S, Khalili H, Vahedi SM, Lessan-Pezeshki M. Serum zinc concentrations in patients on maintenance hemodialysis and its relationship with anemia, parathyroid hormone concentrations and pruritus severity. Saudi J Kidney Dis Transpl 2010;21:641-5.

PMid:20587866

Guo CH, Wangb CL, Chen PC, Yang TC. Linkage of some trace elements, peripheral blood lymphocytes, inflammation, and oxidative stress in patients undergoing either hemodialysis or peritoneal dialysis. Perit Dia Int 2011;31:583-91.

http://dx.doi.org/10.3747/pdi.2009.00225

PMid:20592101

Rucker D, Thadhami R, Tonelli M. Trace Element status in Hemodialysis patients. Sem Dial 2010;23:389-95.

http://dx.doi.org/10.1111/j.1525-139X.2010.00746.x

PMid:20557491

Sen S, Bor N, Colakoglu M, Gultekin A. Clearance of zinc and copper during hemodialysis. MJIAS 1991;4:265-7.

Prasad A. Zinc in growth and development and spectrum of human zinc deficiency. J Am Coll Nut 1988;7:377-84.

http://dx.doi.org/10.1080/07315724.1988.10720255

Rink L, Gabriel P. Zinc and the human system. Proc Nutr Soc 2000;59:541-52.

http://dx.doi.org/10.1017/S0029665100000781

Mokrzycki M, Zhang M, Cohen H, Gdestaneh L, Laut J, Rosenberg S. Tunnelled haemadialysis catheter bacteraemia: risk factors for bacteraemia recurrence, infections complications and mortality. Nephrol Dial Transpl 2006;21:1024-31.

http://dx.doi.org/10.1093/ndt/gfi104

PMid:16449293

Halliwell B. Ascorbic acid, iron overload and desferrioxamine. Br Med J Clin Res Ed 1982;285: 296.

http://dx.doi.org/10.1136/bmj.285.6337.296

PMid:6807463 PMCid:PMC1499653

Ortega R, Requejo A, Andress P, Lopez-sobaler A, Quintas M, Redondo M et al. Dietary intake and cognitive function in a group of elderly people. Am J Clin Nutr 1997; 66: 803-9.

PMid:9322553

Zagrodzki P, Bartorn H, Walas S, Folta M, Stompor T, Janusz-Grzybowska E et al. Selenium status indices, laboratory data, and selected biochemical parameters in end-stage renal disease patients. Biol Trace Elem Res 2007;116:29-41.

http://dx.doi.org/10.1007/BF02685916

PMid:17634625

Fujishima Y, Ohsawa M, Itai K, Kato K, Tanno K, Turin TC et al. Serum selenium levels in hemodialysis patients are significantly lower than those in healthy controls. Blood Purif 2011a;32:43-7.

http://dx.doi.org/10.1159/000323538

PMid:21311185

Pakfetrat M, Malekmakan L, Hasheminasab M. Diminished selenium levels in hemodialysis and continuous ambulatory peritoneal dialysis patients. Biol Trace Elem Res 2010;137:335-9.

http://dx.doi.org/10.1007/s12011-009-8588-2

PMid:20039146

Andrew NH, Engel B, Hart K, Passey C, Beaden S. Micronutrient intake in hemodialysis patients. J Human Nutr Diet 2008;21:375-6.

http://dx.doi.org/10.1111/j.1365-277X.2008.00881_4.x

Walston J, Xue Q, Semba RD, Ferrucci L, Cappola AR, Ricks M et al. Serum antioxidants, inflammation, and total mortality in older women. Am J Epidemiol 2006;163:18-26.

http://dx.doi.org/10.1093/aje/kwj007

PMid:16306311

Viron B. The point about uremia and cancer. Nephrologie 2002; 23: 231-6.

PMid:12369395

Floresmateo G, Navas-Acien A, Pastor – Barriuso R, Guallar E. Selenium and coronary heart disease a meta – analysis. Am J Clin Nutr 2006;84:762-73.

Girelli D, Olivieri O, stazal A, Azzim M, Lupo. Low platelet glutathione peroxidase activity and serum selenium concentration in patientswith chronic renal failure: relations to dialysis treatments, dietary cardiovascular complications. Clin Sol Lond 1993;84:611-7.

Fujishima Y, Ohsawa M, Itai K, Kato K, Tanno K, Turin TC et al. Serum selenium levels are inversely associated with death risk among hemodialysis patients. Nephrol Dial Transplant 2011b, [Epub ahead of print].

http://dx.doi.org/10.1093/ndt/gfq859

PMid:21372251

Klotz L, Kroneoke K, Buchizyk D, Sies H. Role of copper, Zinc selenium and tellurium in the cellular defense against oxidative and hitrosative stress. J Nutr 2003;133:14485-515.

Ward R, McLeich K. Oxidant stress in haemodialysis patients what are the determining factors. Artif Organs 2003;27:230-6.

http://dx.doi.org/10.1046/j.1525-1594.2003.07170.x

Shouman MG, Ibrahim HY, Salama EEE, El-Khayat Z, Ashour M. Trace elements in pediatric hemodialysis patients. Res J Medicine & Med Sci 2009; 4: 435-40.

Guo CH, Ko WS, Chen PC, Hsu GS, Lin CY, Wang CL. Alterations of trace elements and oxidative stress in uremic patients with dementia. Biol Trace elem Res 2009;131:13-24.

http://dx.doi.org/10.1007/s12011-009-8342-9

PMid:19242659




DOI: http://dx.doi.org/10.14259%2Fcs.v1i2.51

Refbacks

  • There are currently no refbacks.