Home About us Current issue Back issues Submission Instructions Advertise Contact Login   

Search Article 
  
Advanced search 
 
Saudi Journal of Kidney Diseases and Transplantation
Users online: 1876 Home Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size 
 

Table of Contents   
LETTER TO THE EDITOR  
Year : 2012  |  Volume : 23  |  Issue : 4  |  Page : 836-837
Does zinc supplementation help in the treatment of anemia in patients on hemodialysis?


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

Click here for correspondence address and email

Date of Web Publication9-Jul-2012
 

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 2020 Dec 3];23:836-7. Available from: https://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.

 
   References Top

1.Smith OB, Akinbamizo OO. Micronutrients and reproduction in farm animals. Anim Reprod Sci 2000;60-61:549-60.  Back to cited text no. 1
    
2.Xia J, Browning JD, O'Dell BL. Decreased plasma membrane thiol concentration is asso­ciated with increased osmotic fragility of erythrocytes in zinc-deficient rats. J Nutr 1999;129:814-9.  Back to cited text no. 2
[PUBMED]  [FULLTEXT]  
3.Johanning GL, O'Dell BL. Effect of zinc defi­ciency and food restriction in rats on erythrocyte membrane zinc, phospholipid and protein content. J Nutr 1989;119:1654-60.  Back to cited text no. 3
[PUBMED]  [FULLTEXT]  
4.Chen SM, Wang CC, Lin F, Young TK. Absent effect of zinc deficiency on the oxidative stress of erythrocytes in chronic uremic rats. Chin J Physiol 2002;45:9-17.  Back to cited text no. 4
[PUBMED]  [FULLTEXT]  
5.Candan F, Gültekin F, Candan F. Effect of vitamin C and zinc on osmotic fragility and lipid peroxidation in zinc-deficient haemodialysis patients. Cell Biochem Funct 2002; 20:95-8.  Back to cited text no. 5
    
6.Parsad SA. Recognition of zinc deficiency syndrome. Nutrition 2001;17:69-76.  Back to cited text no. 6
    
7.Vanholder R, Cornelis R. The role of trace elements in uremic toxicity. Nephrol Dial Transplant 2002;17(suppl 2):2-8.  Back to cited text no. 7
    
8.Lee SH, Huang JW. Trace metals abnormalities in hemodialyzed patients, relationship with medications. Artic Organs 2000;24:841-4.  Back to cited text no. 8
    
9.Coyne DW. Managing anemia in for-profit dialysis chains: when ethics and business conflict. Semin Dial 2009;22:18-21.  Back to cited text no. 9
[PUBMED]  [FULLTEXT]  
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.  Back to cited text no. 10
    

Top
Correspondence Address:
Maryam Sharifian
Department of Neurology; Student Research Committee, Shiraz University of Medical Sciences, Shiraz
Iran
Login to access the Email id


DOI: 10.4103/1319-2442.98177

Rights and Permissions




 

Top
   
 
 
    Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
    Email Alert *
    Add to My List *
* Registration required (free)  
 


 
    References
 

 Article Access Statistics
    Viewed5835    
    Printed64    
    Emailed0    
    PDF Downloaded500    
    Comments [Add]    

Recommend this journal