Distribution of serum zinc levels in hemodialysis patients–factors related to hypozincemia–

Abstract

【Objectives】This study investigated the distribution of serum zinc levels and the factors related to hypozincemia in hemodialysis (HD) patients.【Methods】Serum zinc levels were measured in 518 HD patients. The relationships between serum zinc levels and patient background factors, serum biochemical factors, or drug usage were analyzed. In addition, we compared 2 groups with serum zinc levels of <60 μg/dL and ≧60 μg/dL based on the diagnostic criteria for zinc deficiency.【Results】The median serum zinc level was 59 (52-67) μg/dL. The serum zinc level was not related to age, sex, body mass index, diabetes mellitus, or the dialysis time slot (morning/afternoon/evening), but it was positively correlated with the dialysis vintage. In addition, the patients on hemodiafiltration (HDF) had lower serum zinc levels than those on HD. Multiple regression analysis showed that dialysis vintage and the serum levels of creatinine, Na, triglycerides, albumin (Alb), alkaline phosphatase (ALP), and hematocrit were significant independent predictors of the serum zinc level. Fifty-one percent of patients had serum zinc levels of <60 μg/dL. Binomial logistic regression analysis showed that HDF and the serum levels of phosphorus (P), Alb, and ALP were significant independent predictors of hypozincemia. On the other hand, serum zinc levels were not correlated with the erythropoiesis-stimulating agent (ESA) dosage, ESA resistance index, or the use of other drugs.【Conclusion】Approximately half of dialysis patients have serum zinc levels of <60 μg/dL. The dialysis vintage; HDF; and nutritional factors, such as serum P and Alb levels, were identified as independent predictors of hypozincemia.