Evaluation of zinc replacement therapy for anemia associated with hypozincemia in hemodialysis patients

Abstract

[Introduction] The efficacy of zinc (Zn) replacement therapy for anemia associated with hypozincemia in hemodialysis (HD) patients has not been clearly defined. [Subjects] Thirty-three HD patients who received >9,000 U per week of erythropoietin and exhibited serum Zn levels of <80 μg/dL were enrolled in this study. [Methods] The patients were prescribed 45-50 mg of Zn per day from the start of the study. [Results] After 3 months’ treatment, the patients’ serum Zn levels were significantly increased, but their serum copper (Cu) levels were decreased. The patient’s erythropoietin resistance indexes (ERI) were significantly lower after 3 months’ treatment than at the start of the therapy. [Conclusion] It appears that Zn replacement therapy is useful for treating erythropoietin-resistant anemia in HD patients. However, even if Zn replacement therapy is only used for a short period, such as for 3 months, the risk of hypocupremia is quite high. Thus, it is necessary to routinely measure HD patients’ Zn and Cu levels during Zn replacement therapy.