Zinc, copper and aluminium in the corpuscular components of peripheral blood in patients with pre-terminal and terminal renal failure

Abstract

Trace elements play an essential role in the activation and regulation of metabolic processes. By using the flameless graphite furnace-AAS, accurate results can be obtained. In order to verify blood cells as more representative than plasma to reflect the whole body content of trace elements at uremic state, two patient groups, one with preterminal renal failure (n=40) and the second with chronic renal failure undergoing hemodialysis (n=20) were examined. The concentration levels of zinc, copper and aluminium were measured in different matrices, i.e. whole blood, plasma and corpuscular blood components. The analytical technique is eligible to isolate mono- and polymorphnuclear leucocytes for the determination of intracellular contents. In agreement with other reports, zinc and copper were decreased and aluminium was increased in the plasma of both patient groups. Different results could be found for intracellular contents with mean zinc concentration of erythrocytes, thrombocytes and leucocytes between mean and higher levels, though staying within normal values. Copper was decreased in erythrocytes and increased in thrombocytes, but not detectable in leucocytes. The results of this study point out the differences between the plasmatic and intracellular alteration of trace element contents in uremic patients. However, the concentration levels of all cellular compartments show high standard deviation, which shows the necessity of measuring additional matrices, e.g. plasma. Uremic symptoms relate to the disorders of the trace element homeostasis. Regarding the increased fragility of erythrocytes with shortened life duration, decreased copper contents could play an essential role. Increased aluminium concentration levels might also be one of the interfering factors in the uremic thrombocytopathy. Yet the measurement of the plasma content is inevitable to diagnose and reflect the whole body content of trace elements at uremic state. By keeping analysis control, important information about progression and influence of therapy can be obtained.