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 Health  Vol.8 No.4 , February 2016
The Role of Zinc in Chronic Kidney Disease Patients on Hemodialysis: A Systematic Review
Abstract: Objective: Zinc has been studied for its antioxidant and anti-inflammatory properties and also for its immune function in end stage renal disease patients. The aim of this review is to clarify whether there is a relationship between zinc levels and ESRD patients in hemodialysis. Methodology: A search through LILACS and MEDLINE database using the keywords “zinc”, “chronic kidney disease” and “hemodialysis” was performed. Articles in English and Portuguese performed in humans with the previous words were selected. Studies with subjects younger than 18 years of age were excluded. Moreover, exclusion criteria included patients with absence of diagnosis of end stage renal disease and not in hemodialysis; patients treated with peritoneal dialysis, absence of abstract available, absence of clear association between zinc deficiency and worse prognosis. Results: The search found a total of 214 articles. A total of 44 publications were selected after appliance of exclusion criteria. Conclusion: Zinc deficiency is highly prevalent, and it not only showed influence on inflammatory and immunological processes, but also interfered with metabolism and other systems. Zinc supplementation was considered positive. In summary, lower zinc levels are related to end stage renal disease patients in hemodialysis and supplementation seems to be a promising approach in such cases.
Cite this paper: Neto, L. , Bacci, M. , Sverzutt, L. , Costa, M. , Alves, B. and Fonseca, F. (2016) The Role of Zinc in Chronic Kidney Disease Patients on Hemodialysis: A Systematic Review. Health, 8, 344-352. doi: 10.4236/health.2016.84036.
References

[1]   Jern, N.A., VanBeber, A.D., Gorman, M.A., Weber, C.G., Liepa, G.U. and Cochran, C.C. (2000) The Effects of Zinc Supplementation on Serum Zinc Concentration and Protein Catabolic Rate in Hemodialysis Patients. Journal of Rental Nutrition, 10, 148-153.
http://dx.doi.org/10.1053/jren.2000.7413

[2]   Ribeiro, M.M., Araújo, M.L., Netto, M.P. and Cunha, L.M. (2011) Effects of Customary Dinner on Dietetical Profile of Patients Undergoing Hemodialysis. Jornal Brasileiro de Nefrologia, 33, 69-77.
http://dx.doi.org/10.1590/S0101-28002011000100010

[3]   Veighey, K., Booth, J. and Davenport, A. (2011) Does the Choice of Phosphate Binder Affect Trace Element Levels in Chronic Kidney Disease Patients Treated by Regular Haemodialysis? Nephrology Dialysis Transplantation, 26, 1006- 1010.
http://dx.doi.org/10.1093/ndt/gfq520

[4]   Aranha, L.N., Lobo,J..C, Stockler-Pinto, M.B., Leal, V.D., Torres, J.P. and Mafra, D. (2012) Relationship between Zinc Levels and Plasma Leptin in Hemodialysis Patients. Journal of Trace Elements in Medicine and Biology, 26, 238- 242.
http://dx.doi.org/10.1016/j.jtemb.2012.02.007

[5]   Szpanowska-Wohn, A., Kolarzyk, E. and Chowaniec, E. (2008) Estimation of Intake of Zinc, Copper and Iron in the Diet of Patients with Chronic Renal Failure Treated by Haemodialysis. Biological Trace Element Research, 124, 97-102.
http://dx.doi.org/10.1007/s12011-008-8131-x

[6]   Navarro-Alarcon, M., Reyes-Perez, A., Lopez-Garcia, H., Palomares-Bayo, M., Olalla-Herrera, M. and Lopez- Martinez, M.C. (2006). Longitudinal Study of Serum Zinc and Copper Levels in Hemodialysis Patients and Their Relation to Biochemical Markers. Biological Trace Element Research, 113, 209-222.
http://dx.doi.org/10.1385/BTER:113:3:209

[7]   McGrath, L.T., Douglas, A.F., McClean, E., Brown, J.H., Doherty, C.C., Johnston, G.D., et al. (1995) Oxidative Stress and Erythrocyte Membrane Fluidity in Patients Undergoing Regular Dialysis. Clinica Chimica Acta, 235, 179-188.
http://dx.doi.org/10.1016/0009-8981(95)06027-x

[8]   Pawlak, K., Borawski, J., Naumnik, B. and Mysliwiec, M. (2003) Relationship between Oxidative Stress and Extrinsic Coagulation Pathway in Haemodialyzed Patients. Thromb Res, 109, 247-251.
http://dx.doi.org/10.1016/S0049-3848(03)00241-X

[9]   Jern, N.A., VanBeber, A.D., Gorman, M.A., Weber, C.G., Liepa, G.U. and Cochran, C.C. (2003) The Effects of Zinc Supplementation on Serum Zinc Concentration and Protein Catabolic Rate in Hemodialysis Patients. Journal of Renal Nutrition, 10, 148-153.
http://dx.doi.org/10.1053/jren.2000.7413

[10]   Senft, V., Racek, J., Motán, J., Krízek, M., Bejcková, H. and Kohout, J. (2003) An Evaluation of the Influence of Therapeutic Interventions on Serum Trace Element Levels in Groups of Patients. Journal of Trace Elements in Medicine and Biology, 17, 7-11.
http://dx.doi.org/10.1016/S0946-672X(03)80039-1

[11]   Philipp, A., Kralisch, S., Bachmann, A., Lossner, U., Kratzsch, J., et al. (2011) Serum Levels of the Adipokine Zinc-α2-Glycoprotein Are Increased in Chronic Hemodialysis. Metabolism: Clinical and Experimental, 60, 669-672.

[12]   Ribeiro, R.C., Sales, V.S., Neves, F.A.R., Draibe, S. and Brandao-Neto, J. (2004) Effects of Zinc on Cell-Mediated Immunity in Chronic Hemodialysis Patients. Biological Trace Element Research, 98, 209-218.
http://dx.doi.org/10.1385/BTER:98:3:209

[13]   Roozbeh, J., Hedayati, P., Sagheb, M.M., et al. (2009) Effect of Zinc Supplementation on Triglyceride, Cholesterol, LDL, and HDL Levels in Zinc-Deficient Hemodialysis Patients. Renal Failure, 31, 798-801.
http://dx.doi.org/10.3109/08860220903216055

[14]   Rahimi-Ardabili, B., Argani, H., Ghorbanihaghjo, A., Rashtchizadeh, N., Naghavi-Behzad, M., Ghorashi, S. and Nezami, N. (2012) Paraoxonase Enzyme Activity Is Enhanced by Zinc Supplementation in Hemodialysis Patients. Renal Failure, 34, 1123-1128.
http://dx.doi.org/10.3109/0886022X.2012.717479

[15]   Yaldizli, O., Johansson, U., Gizewski, E.R. and Maschke, M. (2006) Copper Deficiency Myelopathy Induced by Repetitive Parenteral Zinc Supplementation during Chronic Hemodialysis. Journal of Neurology, 253, 1507-1509.
http://dx.doi.org/10.1007/s00415-006-0259-z

[16]   Sorensen-Zender, I., Beneke, J., Schmidt, B.M.W., Menne, J., Haller, H., Schmitt, R., et al. (2013) Zinc-α2-Glyco-protein in Patients with Acute and Chronic Kidney Disease. BMC Nephrology, 14, 145.
http://dx.doi.org/10.1186/1471-2369-14-145

[17]   Magalhaes, R.C.N., Araujo, C.G.B., Sousa Lima, V.B., Moita Neto, J.M., Nogueira, N.N. and Marreiro, D.N. (2011) Nutritional Status of Zinc and Activity Superoxide Dismutase in Chronic Renal Patients Undergoing Hemodialysis. Nutricion Hospitalaria, 26, 1456-1461.

[18]   Kreft, B., Fischer, A., Kruger, S., Sack, K., Kirchner, H. and Rink, L. (2000) The Impaired Immune Response to Diphtheria Vaccination in Elderly Chronic Hemodialysis Patients Is Related to Zinc Deficiency. Biogerontology, 1, 61-66.
http://dx.doi.org/10.1023/A:1010077622172

[19]   Rashidi, A.A., Salehi, M., Piroozmand, A. and Sagheb, M.M. (2009) Effects of Zinc Supplementation on Serum Zinc and C-Reactive Protein Concentrations in Hemodialysis Patients. Journal of Renal Nutrition, 19, 475-478.
http://dx.doi.org/10.1053/j.jrn.2009.04.005

[20]   Washio, K., Inagaki, M., Tsuji, M., Morio, Y., Akiyama, S., Gotoh, H., Gotoh, T., Gotoh, Y. and Oguchi, K. (2008) Oral Vitamin C Supplementation in Hemodialysis Patients and Its Effect on the Plasma Level of Oxidized Ascorbic Acid and Cu/Zn Superoxide Dismutase, an Oxidative Stress Marker. Nephron Clinical Practice, 109, 49-50.
http://dx.doi.org/10.1159/000137628

[21]   Koca, T., Berber, A., Koca, H.B., Demir, T.A. and Koken, T. (2010) Effects of Hemodialysis Period on Levels of Blood Trace Elements and Oxidative Stress. Clinical and Experimental Nephrology, 14, 463-468.
http://dx.doi.org/10.1007/s10157-010-0310-3

[22]   Guo, C.H., Wang, C.L., Chen, P.C. and Yang, T.C. (2011) Linkage of Some Trace Elements, Peripheral Blood Lymphocytes, Inflammation, and Oxidative Stress in Patients Undergoing either Hemodialysis or Peritoneal Dialysis. Peritoneal Dialysis International, 31, 583-591.
http://dx.doi.org/10.3747/pdi.2009.00225

[23]   Christopoulos, A.I., Diamantopoulos, A.A., Dimopoulos, P.A., Goumenos, D.S. and Barbalias, G.A. (2009) Risk Factors for Tuberculosis in Dialysis Patients: A Prospective Multi-Center Clinical Trial. BMC Nephrology, 10, 36.
http://dx.doi.org/10.1186/1471-2369-10-36

[24]   Sagheb, M.M., Sajjadi, S. and Sajjadi, G. (2009) A Study on the Protection of Hemodialysis Patients against Diphtheria and Tetanus. Renal Failure, 31, 904-909.
http://dx.doi.org/10.3109/08860220903268353

[25]   Najafabadi, M.M., Faghihi, G., Emami, A., Monghad, M., Moeenzadeh, F., Sharif, N. and Davarpanah Jazi, A.H. (2012) Zinc Sulfate for Relief of Pruritus in Patients on Maintenance Hemodialysis. Therapeutic Apheresis and Dialysis, 16, 142-145.
http://dx.doi.org/10.1111/j.1744-9987.2011.01032.x

[26]   Yang, C.Y., Wu, M.L., Chou, Y.Y., Li, S.Y., Deng, J.F., Yang, W.C. and Ng, Y.Y. (2012) Essential Trace Element Status and Clinical Outcomes in Long-Term Dialysis Patients: A Two-Year Prospective Observational Cohort Study. Clinical Nutrition, 31, 630-636.
http://dx.doi.org/10.1016/j.clnu.2012.02.008

[27]   Lee, S.H., Huang, J.W., Hung, K.V., et al. (2000) Trace Metals’ Abnormalities in Hemodialysis Patients, Relationship with Medications. Artificial Organs, 24, 841-844.
http://dx.doi.org/10.1046/j.1525-1594.2000.06352.x

[28]   Guo, C.-H., Chen, P.-C., Hsu, G.-S.W. and Wang, C.-L. (2013) Zinc Supplementation Alters Plasma Aluminum and Selenium Status of Patients Undergoing Dialysis: A Pilot Study. Nutrients, 5, 1456-1470.
http://dx.doi.org/10.3390/nu5041456

[29]   Pelletier, C.C., Koppe, L., Croze, M.L., Kalbacher, E., Vella, R.E., Guebre-Egziabher, F., et al. (2013) White Adipose Tissue Overproduces the Lipid-Mobilizing Factor Zinc α2-Glycoprotein in Chronic Kidney Disease. Kidney International, 83, 878-886.
http://dx.doi.org/10.1038/ki.2013.9

[30]   Besarab, A., Amin, N., Ahsan, M., Vogel, S.E., Zazuwa, G., et al. (2000) Optimization of Epoetin Therapy with Intravenous Iron Therapy in Hemodialysis Patients. Journal of the American Society of Nephrology, 11, 530-538.

[31]   Fukushima, T., Horike, H., Fujiki, S., Kitada, S., Sasaki, T. and Kashihara, N. (2009) Zinc Deficiency Anemia and Effects of Zinc Therapy in Maintenance Hemodialysis Patients. Therapeutic Apheresis and Dialysis, 13, 213-219.

[32]   Hosokawa, S. and Yoshida, O. (1995) Effect of Recombinant Human Erythropoietin (rHuEPO) on Protein, Zinc (Zn), Nickel (Ni) and Manganese (Mn) in Patients Undergoing Chronic Haemodialysis. International Urology and Nephro- logy, 27, 207-214.
http://dx.doi.org/10.1007/BF02551322

[33]   Rubio, I., Caramelo, C., Gil, A., Lopez, M.D. and Garcia de Yebenes, J. (2006) Plasma Amyloid-β, Aβ1-42, Load Is Reduced by Haemodialysis. Journal of Alzheimer’s Disease, 10, 439-443.

[34]   Jalali, G.R., Roozbeh, J., Mohammadzadeh, A., Sharifian, M., Sagheb, M.M., Hamidian Jahromi, A., Shabani, S., Ghaffarpasand, F. and Afshariani, R. (2010) Impact of Oral Zinc Therapy on the Level of Sex Hormones in Male Patients on Hemodialysis. Renal Failure, 32, 417-426.
http://dx.doi.org/10.3109/08860221003706958

[35]   Ari, E., Kaya, Y., Demir, H., Asicioglu, E. and Keskin, S. (2011) The Correlation of Serum Trace Elements and Heavy Metals with Carotid Artery Atherosclerosis in Maintenance Hemodialysis Patients. Biological Trace Element Research, 144, 351-359.

[36]   Raimundo, P., Ravasco, P., Proen?a, V. and Camilo, M. (2006) Does Nutrition Play a Role in the Quality of Life of Patients under Chronic Haemodialysis? Nutricio?n Hospitalaria, 21, 139-144.

[37]   Roozbeh, J., Sharifian, M., Ghanizadeh, A., Sahraian, A., Sagheb, M.M., Shabani, S., et al. (2001) Association of Zinc Deficiency and Depression in the Patients with End-Stage Renal Disease on Hemodialysis. Journal of Renal Nutrition, 21, 184-187.
http://dx.doi.org/10.1053/j.jrn.2010.05.015

[38]   D’Haese, P.C., Couttenye, M.M., Lamberts, L.V., Elseviers, M.M., Goodman, W.G., Schrooten, I., Cabrera, W.E. and De Broe, M.E. (1999) Aluminum, Iron, Lead, Cadmium, Copper, Zinc, Chromium, Magnesium, Strontium, and Calcium Content in Bone of End-Stage Renal Failure Patients. Clinical Chemistry, 45, 1548-1556.

[39]   Ochi, A., Ishimura, E., Tsujimoto, Y., Kakiya, R., Tabata, T., Mori, K., Tahara, H., Shoji, T., Yasuda, H., Nishizawa, Y., et al. (2012) Elemental Concentrations in Scalp Hair, Nutritional Status and Health-Related Quality of Life in Hemodialysis Patients. Therapeutic Apheresis and Dialysis, 16, 127-133.
http://dx.doi.org/10.1111/j.1744-9987.2011.01043.x

[40]   Dvornik, S., Cuk, M., Racki, S. and Zaputovic, L. (2006) Serum Zinc Concentrations in the Maintenance Hemodialysis Patients. Collegium Antropologicum, 30, 125-129.

 
 
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