Evaluation of Serum Zinc Level among Hemodialysis Sudanese Patients with Erythropoietin Resistant
Amal Elbadri || Department of Clinical ChemistryFaculty of Medical Laboratory SciencesAlneelien University – KhartoumSudan.
Volume : (13), Issue : 205, February - 2018
Abstract : Background: Anemia is principle health problem in patients with chronic renal failure on hemodialysis treatment and erythropoietin is treatment of choice, some patients do not respond as expected. Various researches suggest that zinc may play a role in the etiology of erythropoietin resistant anemia.
Objectives: To assess serum zinc level in erythropoietin resistant hemodialysis Sudanese patients and its relation to hemoglobin and comparison with apparently non erythropoietin resistant hemodialysis control patients.
Materials and methods: Case control study was performed in Khartoum state at kidney disease clinic Khartoum Sudan, during the period from February to October 2018. 50 samples were collected from erythropoietin resistant Hemodialysis patients test group. In addition to other 50 from non-erythropoietin resistant hemodialysis patient’s sex and age matched control group. The levels of serum zinc elements were determined in both groups by atomic absorption spectroscopy, and hemoglobin was measured by colorimetric method.
Results: Serum zinc level was significantly lower in erythropoietin resistant hemodialysis patients when compared with non-erythropoietin resistant hemodialysis patients control group (0.26 ± 0.08 mg/L versus 0.67 ±0.09 mg/L). Furthermore Hb was significantly decreased (8.56 ± 0.56 gm/L versus 11.34 ± 0.59 gm/dl, p=0.000). In addition the study observed no significant difference in zinc level and hemoglobin across gender (P>0.05) in the test group. Also the study recorded serum zinc level is significantly correlated with Hb (R=0.58, P=0.00) and inversely correlated with age (R=-43, P=0.01). Whereas Hb level is insignificantly correlated with patients age in the study group (R=0.24, p=0.16).
Conclusion: Erythropoietin resistant anemia in hemodialysis patients is associated with reduced serum zinc level. Which provide evidence that serum zinc levels should be measure especially in hemodialysis patients resistant to erythropoietin therapy.
Keywords :Chronic renal failure; Hemodialysis erythropoietin resistant; Zinc; Hemoglobin.
Cite This Article:
Sudanese Patients with Erythropoietin Resistant
Article No : 10090
Number of Downloads : 101
Thomas R, Kanso A, Sedor JR (2008) Chronic Kidney disease and its complication. Prim Care 35: 329-344.
Liuzzi JB, Lichten LA, Rivera S, Blanchard RK, Aydemir TB, et al. (2005) Interleukin-6 regulates the zinc transporter Zip 14 in liver and contributes to the hypozinncemia of the acute-phase response. Pro Natl Acad Sci USA 102: 6843-6848.
Mahon A, Bennett L (2007) Renal anemia; recent development and rupture directions for improved... More
- Thomas R, Kanso A, Sedor JR (2008) Chronic Kidney disease and its complication. Prim Care 35: 329-344.
- Liuzzi JB, Lichten LA, Rivera S, Blanchard RK, Aydemir TB, et al. (2005) Interleukin-6 regulates the zinc transporter Zip 14 in liver and contributes to the hypozinncemia of the acute-phase response. Pro Natl Acad Sci USA 102: 6843-6848.
- Mahon A, Bennett L (2007) Renal anemia; recent development and rupture directions for improved management. J Renal Care 33: 108-114.
- Roger SD (2008) Extended administration of erythropoiesis- stimulating agents for optimizing the management of renal anemia: what is the evidence? Int J Cline Pract 62: 1413-1422.
- McClellan W, Aronoff SL, Bolton WK, Hood S, Lorber DL, et al. (2004) The prevalence of anemia in patients with chronic kidney disease. Curr Med Res Opin 20: 1501-1510.
- Lopez-Gomezv JM, Portoles JM, Aljama P (2008) Factors that conditon the response to erythropoietin on bemodialysis and their relaton to mortality. Kidney Int Suppt 111: S75-S81.
- Rucker D, Thadhani R, Tonelli M (2010) Trace element status in hemodialysis patients. Semin Dial 23: 389-395.
- Pdrasad AS, Miale A Jr, Farid Z, Sandstead HH, Schulert AR (1963) Zinc metabolism in patients with the syndrome of iron deficiency anemia, hepatosplenomegaly, dwarfism and hpypogonadism. J Lab Clin Med 61: 537.
- Kalantar-Zadeh K, Kopple JD (2003) Trace metals and vitamins in maintence dialysis patients. Adv Ren Replace Ther 10: 170-182.
- Cabral PC, Diniz AS, Arruda LK (2005) Vitamin A and zinc status in patients on maintenance haemodialysis. Nephrology 10:459-463.
- Mahajan SK, Bowersox EM, Rye DL (1989) Factors undergoing abnormal zinc metabolism in uremia. Kidney Int 36: S269-273.
- Taylor A, Branch S, Halls D, Patriarca M, White M (2002) Atomic spectromety update. Clinical and biological materials, foods and beverages. J Anal Atom Spectrom 17: 414-455.
- Weiss G, Goodnough LT (2005) Anemia of chronic disease. New Engl J Med 352: 1011-1023.
- Arcasoy A, Cavdar AO, Babacan E (1978) Decreased iron and zinc absorpton in. Turkish children with iron deficiency and geophagia. Acta Haematol 60: 76-84.
- Lonnerdal B (2000) Dietary factors influencing zinc absorption. J Nutr 130: 1378S-1383S.
- Kilic I, Ozalp I, Coskun T, Tokatli A, Emre S, et al. (1998) The effect of zinc-supplemented bread consumption on school children with asymptomatic zinc deficiency. J Pediatr Gastroenterol Nutr 26: 167-171.
- Prasad AS, Halsted JA, Nadimi M (1961) Syndrome of iron deficiency anemia hepatosplenomegaly, hypogonadism, dwarfism and geoghagia. Am J Med 31: 532-546.
- Dashti-Khavidaki S, Khalili H, Seyedeh-Maryam V, Lessan- Pezeshki M (2010) Serum Zinc Concentrations in Patients on Maintenance Hemodialysis and its Relationship with Anemia, Parathyroid Hormone Concentrations and Pruritus Severity. Saudi J Kidney Dis Transpl 21: 641-645.
- Dvornik S, Cuk M, Racki S, Zaputovic L (2006) Serum zinc concentrations in maintenance hemodialysis patients. Coll Antropol 30: 125-129.
- Yegenaga I, Aydin Z (2014) Low Serum Zinc Level May be Related to Higher Doses of EPO in Hemodialysis Patients. BANTAO J 12:40-44.
- Candan F, Gultekin F, Candan F (2002) Effect of vitamin C and zinc on osmotic fragility and lipid peroxidation in zinc-deficient haemodialysis patients. Cell Biochem Funct 20: 95-98.
- Tonelli M, Wiebe N, Hemmelgarn B, Klarenbach S, Field C, et al. (2009) Trace elements in hemodialysis patients: a systematic review and meta-analysis. BMC Medicine 7: 25.
- Randrianarison-Huetz V, Laurent B, Bardet V, Blobe GC, Huetz F, et al. (2010) Gfi-1B controls human erythroid and megakaryocytic differentiation by regulating TGF-beta signaling at the bipotent erythro-megakaryocytic progenitor stage. Blood 115: 2784-2795.
- Osawa M, Yamaguchi T, Nakamura Y, Kaneko S, Onodera M, et al. (2002) Erythroid expansion mediated by the Gfi-1B zinc finger protein: Role in normal hematopoiesis. Blood 100: 2769-2777.
- Fukushima T, Horike H, Fujiki S, Kitada S, Sasaki T, et al. (2009) Zinc deficiency anemia and effects of zinc therapy in maintenance hemodialysis patients. Ther Apher Dial 13: 213-219.