Trace Elements Status (Zinc & Copper) in Pediatric Patients on Regular Hemodialysis

Abstract

Background Hemodialysis patients are at risk for deficiency of essential trace elements and excess of toxic trace elements, both of which can affect health. Objectives Up to our knowledge, there is no previous data about the normal values of trace elements in pediatric hemodialysis patient, so our aim was to evaluate the status of both serum zinc & copper in our pediatric hemodialysis patients in order to evaluate the need for supplementation. Methodology This is a case control study which involved 2 groups: Patients’ group included 60 children with end stage kidney disease on regular hemodialysis following up at Pediatric Dialysis Unit, Ain Shams University Hospitals and 60 healthy children served as a control group. Measurements of serum copper and zinc were performed by atomic absorption spectrophotometry, complete blood count (CBC), iron and lipid profiles were done and correlated to serum copper and zinc level. Results Patients’ group were 32 males (53.3%) and 28 females (46.6%) with an average age of 13.06 ± 2.08, 8-17 years, BMI of (15.07 ± 3.30, 8.38-21.14 Kg/m2) and duration of hemodialysis was (3.28 ± 2.33, 1-10 years). The control group were 39 males (65%) and 21 females (35%) with age of (8 ± 2.14, 5-12 years) and BMI was (16.36 ± 1.30, 14.6-18.5 Kg/m2). Six patients (10%) had low serum zinc level with values between 58 to 59 mcg% (normal:60-120 mcg%), while only two patients (3.3%) had low serum copper level with values of 66 mcg% (normal:70140 mcg%). All control group had normal serum zinc and copper levels with a significant difference between patients and control groups as regards serum copper level (Patients’ group 78.06 ± 7.5 mcg%, control group 82.46 ± 8.13 mcg%, P = 0.03). We found a negative correlation between blood copper and ferritin level (r = 0.334, P value = 0.009). We also found a positive correlation between blood copper and cholesterol level (r = 0.276, P value = 0.033). Conclusion Hemodialysis could lead to depletion of biologically essential trace elements, thus routine monitoring of trace element blood levels is important for proper nutritional support of patients on hemodialysis.