Effects of Hemodialysis on Serum Copper and Zinc Levels in Sudanese Patients with Chronic Kidney Disease
Abstract
Background: Trace elements are essential nutrients with a gamut of functions in human being. Hemodialysis patients are at risk for deficiency of essential trace elements and excess of toxic trace elements, both of which can affect health. Alterations in trace element levels in patients receiving long-term renal replacement therapy have been implicated in immune dysfunction and increased oxidative stress.
Patients and Methods: This was a case control study conducted at Gezira Hospital for Renal Disease and Surgery, Wad Medani, Gezira State, from July 2020 to May 2021 was aimed to evaluate the effect of hemodialysis on serum copper and zinc levels in patients suffering from chronic kidney disease. A total of 90 individuals were included in this study which divided into two groups; 60 healthy person as control group and 30 patients with chronic kidney disease as case group. Blood samples were collected, one time from control group and two times from case group at pre and post dialysis. Serum copper and zinc were estimated with atomic absorption spectroscopy. Data were collected by questionnaire and analyzed by statistical package for social sciences version (21) and medical calculator.
Results: it showed that 66.7% of patients were males and 33.3% were females, 43.3% of patients age from 23-40 year, 40% from 41-57 year and 16.7% from 58-75year, 3.3% patient were underweight, 33.3% were with normal weight, 30% overweight and 33.3% obese. The family history showed that 13.3% had family history and 86.7% had no family history. Duration of disease showed that 60% were less than 5 years and 40% more than 5 years. The history of chronic disease found that 76.7% of patients were hypertensive and 26.7% were diabetic. There is no significant deference in serum zinc levels between pre hemodialysis and control group (p. value 0.656), while, a significantly decrease levels observed after hemodialysis when compared to control group and pre hemodialysis (p. value 0.014 and 0.000). Serum copper levels were significantly decreased in pre hemodialysis and post hemodialysis when compared to control group with P. value (0.000), also serum copper levels were significantly decreased in post hemodialysis when compared with pre hemodialysis with P. value (0.000). Serum copper and zinc levels had weak correlations with age, gender, BMI and duration of hemodialysis, whereas, the level of serum zinc after hemodialysis had strong positive correlation with their levels before dialysis (Person correlation: 0.727 and P. value 0.000). Homolateral, there is strong positive correlation in copper levels between post and pre dialysis (Person correlation: 0.716 and P. value 0.000).
Conclusion: Hemodialysis has an effect on serum copper and zinc levels by decreasing their levels in serum, thus, regular monitoring of serum copper and zinc levels in hemodialysis patients and copper - zinc supplements are recommended after hemodialysis.
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