Abstract
Anemia is a severe complication in patients with chronic kidney disease (CKD). Treatment with exogenous erythropoietin (EPO) can correct anemia in many with CKD. We produced 5/6-nephrectomized rats that became uremic and anemic at 25 days post surgery. Injection of the anemic 5/6-nephrectomized rats with 2.8 mg zinc/kg body weight raised their red blood cell (RBC) levels from approximately 85% of the control to 95% in one day and continued for 4 days. We compared the effect of ZnSO4 and recombinant human erythropoietin (rHuEPO) injections on relieving anemia in 5/6-nephrectomized rats. After three consecutive injections, both the ZnSO4 and rHuEPO groups had significantly higher RBC levels (98 ± 6% and 102 ± 6% of the control) than the saline group (90 ± 3% of the control). In vivo, zinc relieved anemia in 5/6-nephrectomized rats similar to rHuEPO. In vitro, we cultured rat bone marrow cells supplemented with ZnCl2, rHuEPO, or saline. In a 4-day suspension culture, we found that zinc induced erythropoiesis similar to rHuEPO. When rat bone marrow cells were supplement-cultured with zinc, we found that zinc stimulated the production of EPO in the culture medium and that the level of EPO produced was dependent on the concentration of zinc supplemented. The production of EPO via zinc supplementation was involved in the process of erythropoiesis.
Highlights
Anemia is a severe complication in patients with chronic kidney disease (CKD)
These results indicate that the sham operation of the kidney had no effect on the red blood cell (RBC) level of the rats
Supplementation with an adequate amount of zinc to the 5/6-nephrectomized rats relieved their anemia in 1 day, and from 2 days until 4 days, the RBC levels returned to over 95% of those of the control
Summary
Anemia is a severe complication in patients with chronic kidney disease (CKD). A systematic review of hemodialysis patients showed that the zinc level was lower in hemodialysis patients, compared with controls [5], and zinc deficiency was highly prevalent [7]. Lower plasma zinc levels have been found to be related to renal disease. Zinc supplementation to CKD patients was considered beneficial, resulting in higher plasma zinc levels and benefiting the nutritional status of maintenance hemodialysis patients [7,8,9,10]. Adjuvant zinc therapy has been used for zinc-deficient anemic patients, and zinc was found to be an economic choice to reduce the use of rHuEPO in CKD patients on hemodialysis [12,13]. Micronutrients, including zinc, are known to be relevant to blood cell production, some of the mechanisms remain unknown [14]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
