Abstract
【Objective】 Zinc， an essential trace element， circulates in the blood bound to albumin （Alb）. We examined the
relationship between serum zinc levels and all-cause mortality in hemodialysis patients.
【Methods】 We measured the serum zinc levels in 505 chronic hemodialysis patients in our facility and this cohort was followed for approximately 3 years with all-cause mortality as the primary endpoint. Serum zinc levels were
divided into tertiles and analyzed using the Kaplan–Meier method and the Cox proportional hazards model. Subgroup analysis of serum Alb was also performed.
【Results】 Serum zinc levels showed a significant positive association with GNRI （geriatric nutritional risk index） and serum biochemical values reflecting nutritional status such as serum P，Mg，T-chol，TG，TP，Alb，ChE，Hb levels. A total of 61 patients（12.1%）died during the follow-up period. Compared to the first tertile ［serum zinc，49（46-52）μg/dL］，the risk of death was lower in the second tertile ［serum zinc，59（57-61）μg/dL; HR 0.549，95%CI 0.303–0.995，p =0.048］and the third tertile [serum zinc，70（66-74）μg/dL ;HR 0.454，95%CI 0.241–0.857，p =0.015］groups. This relationship remained after adjustment for age and dialysis vintage， but disappeared when Alb was added as a covariate. In the subgroup analysis， better survival with higher zinc status was observed only in patients with Alb of 3.5 and 3.6g/dL. There were no differences in cardiovascular disease-related death， infection-related death， or cancer-related death between the three groups.
【Conclusion】 In dialysis patients， serum zinc levels were associated with life expectancy， but this relationship was affected by Alb.
