Zinc Supplementation Alters Plasma Aluminum and Selenium Status of Patients Undergoing Dialysis: A Pilot Study

Chih-Hung Guo,Chia-Liang Wang,Guoo-Shyng Hsu,Pei-Chung Chen

doi:10.3390/nu5041456

Chih-Hung Guo, Chia-Liang Wang + Show 2 more

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https://doi.org/10.3390/nu5041456

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Abstract

End stage renal disease patients undergoing long-term dialysis are at risk for abnormal concentrations of certain essential and non-essential trace metals and high oxidative stress. We evaluated the effects of zinc (Zn) supplementation on plasma aluminum (Al) and selenium (Se) concentrations and oxidative stress in chronic dialysis patients. Zn-deficient patients receiving continuous ambulatory peritoneal dialysis or hemodialysis were divided into two groups according to plasma Al concentrations (HA group, Al > 50 μg/L; and MA group, Al > 30 to ≤ 50 μg/L). All patients received daily oral Zn supplements for two months. Age- and gender-matched healthy individuals did not receive Zn supplement. Clinical variables were assessed before, at one month, and after the supplementation period. Compared with healthy subjects, patients had significantly lower baseline plasma Se concentrations and higher oxidative stress status. After two-month Zn treatment, these patients had higher plasma Zn and Se concentrations, reduced plasma Al concentrations and oxidative stress. Furthermore, increased plasma Zn concentrations were related to the concentrations of Al, Se, oxidative product malondialdehyde (MDA), and antioxidant enzyme superoxide dismutase activities. In conclusion, Zn supplementation ameliorates abnormally high plasma Al concentrations and oxidative stress and improves Se status in long-term dialysis patients.

Highlights

Patients with end stage renal diseases (ESRD) that require long-term dialysis are a public health concern worldwide
Zn deficient status is associated with immune system disturbances, poor nutritional status, atherosclerosis, high rates of hospitalization due to infections [7,8,9,10], and significant reductions in blood Se concentrations in chronic dialysis patients [11,12]
Recent studies have shown that Zn supplementation increases serum Zn concentrations, improves taste acuity and the protein catabolic rate [14,30], and raises cholesterol, low-density lipoprotein and high-density lipoprotein concentrations [31,32,33] in patients with chronic dialysis

Summary

Introduction

Patients with end stage renal diseases (ESRD) that require long-term dialysis are a public health concern worldwide. Despite dialysis treatment, these patients still have high morbidity and mortality rates [1]. The major contributing risk factors include wasting, an oxidant-antioxidant imbalance, progressive inflammation, impaired immune responsiveness, and infection [2]. Zn deficient status is associated with immune system disturbances, poor nutritional status, atherosclerosis, high rates of hospitalization due to infections [7,8,9,10], and significant reductions in blood Se concentrations in chronic dialysis patients [11,12]. Improved Zn status is associated with alleviating oxidative stress, inflammation, dyslipidemia, and malnutrition in dialysis patients [7,13,14,15]

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