Serum trace elements [aluminium, copper, zinc] in hemodialysis patients

ABSTRACT

Trace element is defined as one that makes up less than 0.01% of body's mass. Those present at micro g/dl in body fluids and at mg/kg in tissues are referred to as trace elements and those found at micro g/dl in body fluids or micro g/kg in tissues are referred to as ultra-trace elements. Although these elements constitute a relatively small amount of total body tissues these are essential for many vital processes. To determine the serum level of trace elements i.e Aluminum [Al], Zinc [Zn] and Copper [Cu] in haemodialysis [HD] patients. Methods: Fifty patients of End Stage Renal disease [ESRD] on [HD] for more than three months from dialysis center of Shalamar Hospital Lahore were included in the study. Patients of acute renal failure, duration less than three months were excluded from the study. Fifteen subjects age and gender matched having normal kidney functions were included as controls. Demographic data was collected in a separate form having age, gender, cause of ESRD, duration of dialysis and viral markers. The major causes of ESRD were diabetic and hypertensive nephropathy. The mean age was 46.10 +/- 16.29 years and predominantly patients were from middle class. Mean duration of dialysis was 24.87 +/- 22.1 months and majority of the patients 40 [74.1%] were on twice weekly dialysis. Mean serum Al level was 65.44 +/- 33.41 micro g/L as compared to controls [13.20 +/- 6.155] which was statistically significant [p<0.001]. Mean serum Zn level was 59.17 +/- 32.51 micro g/L and Cu level was 35.35 +/- 31.52 micro g/L which were significantly [p<0.001] lower than controls [107.53 +/- 13.32, 107.00+11.85 micro g/L]. Duration of the dialysis had negative correlation with serum Zn level. It was significantly [p<0.02] low [44.78 +/- 33.061 micro g/L] when duration of dialysis was more than 30 months as compared to duration less than 30 months [66.36 +/- 30.174 micro g/L]. Serum levels of trace elements were significantly different in ESRD patients. Majority of patients had high Al levels and decreased Cu and Zn level. High serum Al levels in patients were due to intake of Al based phosphate binders. Decreased Zn and Cu levels were due to poor intake and dietary restriction. Duration of the dialysis had negative correlation with serum Zn level