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| Year : 2012 | Volume
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| Issue : 4 | Page : 836-837 |
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| Does zinc supplementation help in the treatment of anemia in patients on hemodialysis? |
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Maryam Sharifian1, Jamshid Roozbeh2, Mohammad Mahdi Sagheb2, Sanaz Shabani3, Alireza Hamidian Jahromi2, Raha Afsharinai4, Oveis Salehi5, Ghanbarali Raais Jalali2
1 Department of Neurology; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
2 Urology Nephrology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
3 Student Research Committee; Urology Nephrology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
4 Department of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran
5 Cardivascular research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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| Date of Web Publication | 9-Jul-2012 |
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How to cite this article:
Sharifian M, Roozbeh J, Sagheb MM, Shabani S, Jahromi AH, Afsharinai R, Salehi O, Jalali GR. Does zinc supplementation help in the treatment of anemia in patients on hemodialysis?. Saudi J Kidney Dis Transpl 2012;23:836-7 |
How to cite this URL:
Sharifian M, Roozbeh J, Sagheb MM, Shabani S, Jahromi AH, Afsharinai R, Salehi O, Jalali GR. Does zinc supplementation help in the treatment of anemia in patients on hemodialysis?. Saudi J Kidney Dis Transpl [serial online] 2012 [cited 2013 May 18];23:836-7. Available from: http://www.sjkdt.org/text.asp?2012/23/4/836/98177 |
To the Editor,
Zinc is an essential trace element. [1] Zinc deficiency results in dysfunction of plasma membrane proteins, which present with some pathological features. [2] Anemia and zinc deficiency are both common in patients with chronic uremia. [3],[4] Oxidative stress of the red blood cells (RBC) and their subsequent life span reduction are suggested to play an important role in the development of anemia in patients with chronic uremia. [4] Zinc deficiency may aggravate the effect of oxidative stress on RBCs in the uremic setting. Moreover, per-oxidation of the RBC membrane leads to anemia in patients on hemodialysis (HD). [5]
In a prospective cohort study, the effect of oral zinc sulfate supplementation on hemoglobin (Hb) level in patients with renal failure was studied. Of the 155 patients with endstage renal disease on HD at The Nemazi Hospital, Shiraz University of Medical Sciences, 41 patients with low zinc level (zinc <70 μg/mL) and normal serum iron were studied. The plasma zinc level was measured using the atomic absorption method from fasting plasma samples, collected in acid-washed tubes; all tests were performed in the same laboratory. The Hb, serum iron level, ferritin and blood urea nitrogen (BUN) were also checked in all the study patients. Patients then received oral zinc supplementation (zinc sulfate; Alhavi Pharma, Iran) (250 mg/day) for six weeks. The Hb, serum iron, ferritin and BUN were re-checked after six weeks. The parametric data are presented as mean [standard deviation (SD)]. The data were analyzed with Student's t-test and paired t-test using SPSS 15 software.
Thirty-eight patients completed the study while three were eliminated due to non-compliance. The mean age of the patients was 53.2 ± 18.2 years (range 21-83). The mean duration on dialysis was 12.1 months (range: 3-51 months). The initial mean zinc concentration was 53.27 ± 15.27 μg/mL, which increased to 80.38 ± 20.54 μg/mL after 42 days of zinc supplementation (P <0.05). The mean Hb level in the patients increased from 9.3 ± 1.33 mg/mL to 10.1 ± 1.85 mg/mL in the same period, which was statistically significant (P <0.05). No significant changes were noted in the serum level of iron from Day 0 (110.0 ± 53.01 mg/mL) to Day 43 (106 ± 44.60 mg/ mL). The serum levels of ferritin and BUN also did not change significantly after supplementation.
The percent prevalence of zinc deficiency in the Middle East and Iran is estimated to be around 30% in healthy individuals. It is significantly more common (40-78%) in patients with chronic diseases such as end-stage renal failure who are on HD. [6],[7],[8],[9],[10] Anemia is associated with a higher mortality rate in HD patients; moreover, treatment of anemia improves the patients' well-being and reduces the need for further transfusions. [9] Zinc deficiency may be a possible causative factor for anemia in these patients, especially those with erythro-poietin-refractory/non-responsive anemia. The Hb concentration after zinc administration increased in this study. This suggests that zinc supplementation as a routine and additive treatment of anemia should be considered while giving erythropoietin in HD patients.
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| 10. | Jalali GR, Roozbeh J, Mohammadzadeh A, et al, Impact of oral zinc therapy on the level of sex hormones in male patients on hemodialysis. Ren Fail 2010;32:417-9.
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Correspondence Address:
Maryam Sharifian
Department of Neurology; Student Research Committee, Shiraz University of Medical Sciences, Shiraz
Iran
DOI: 10.4103/1319-2442.98177
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