Dataset Information

Zinc Burden Evokes Copper Deficiency in the Hypoalbuminemic Hemodialysis Patients.

ABSTRACT: BACKGROUND:Recent research has focused on the roles of trace minerals such as zinc and copper. In 2017, oral zinc acetate was approved to treat zinc deficiency, and the next year, the Japanese Society for Clinical Nutrition developed the guidelines for diagnosis and treatment for zinc deficiency. Accordingly, hemodialysis patients began receiving zinc acetate when zinc deficiency was diagnosed. However, studies regarding the values of zinc and copper in hemodialysis patients are extremely poor, thus it remains unclear if the guidelines for healthy subjects can be applied to hemodialysis patients. METHODS:We conducted a descriptive study, in which 132 patients were subjected to simply examine serum zinc concentration and its association with copper levels in hemodialysis patients (N = 65) versus healthy individuals attending a routine check-up (control group; N = 67) in our hospital. Analyses were performed with BellCurve for Excel (Social Survey Research Information Co., Ltd. Tokyo, Japan). RESULTS:The distribution of zinc level in the hemodialysis group was distinct from that in the control group (P < 0.001). The zinc level was correlated with serum albumin concentration. Zinc concentration was also negatively correlated with serum copper level in both groups. In the hemodialysis group, the upper limit of zinc to avoid copper deficiency was 109.7 ?g/dL, and the safety upper limit was 78.3 ?g/dL. CONCLUSIONS:Hemodialysis patients exhibited a lower level of zinc concentration compared to normal healthy subjects. Since albumin binds to zinc as a carrier, low zinc levels could be attributed to lower level of serum albumin. Importantly, zinc and copper levels were inversely correlated, thus administration of oral zinc acetate could increase a risk for copper deficiency. It might be better to check both zinc and copper values monthly after prescribing zinc acetate.

SUBMITTER: Nishime K

PROVIDER: S-EPMC7071503 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Zinc Burden Evokes Copper Deficiency in the Hypoalbuminemic Hemodialysis Patients.

Nishime Keizo K Kondo Morihiro M Saito Kazuhiro K Miyawaki Hisashi H Nakagawa Takahiko T

Nutrients 20200223 2

<h4>Background</h4>Recent research has focused on the roles of trace minerals such as zinc and copper. In 2017, oral zinc acetate was approved to treat zinc deficiency, and the next year, the Japanese Society for Clinical Nutrition developed the guidelines for diagnosis and treatment for zinc deficiency. Accordingly, hemodialysis patients began receiving zinc acetate when zinc deficiency was diagnosed. However, studies regarding the values of zinc and copper in hemodialysis patients are extremel ...[more]

PMID: 32102170

Similar Datasets

Project description:Zinc is an essential nutrient because of its role in catalysis and in stabilizing protein structure, but excess zinc can also be deleterious. Four nutritional zinc states have been identified in the alga Chlamydomonas reinhardtii: zinc toxic, zinc replete, zinc deficient and zinc limited. Growth is inhibited in zinc-limited and zinc toxic cells relative to zinc-replete cells, while zinc-deficiency is visually asymptomatic but distinguished by the accumulation of transcripts encoding ZIP family transporters. To identify targets of zinc deficiency and mechanisms of zinc acclimation, we used RNA-seq to probe zinc nutrition responsive changes in gene expression. We identified a subset of genes encoding zinc-handling components, including ZIP family transporters and candidate zinc chaperones. In addition, we noted an impact on two other regulatory pathways, the carbon concentrating mechanism (CCM) and the nutritional copper regulon. Targets of transcription factor Ccm1 and various CAH genes are up-regulated in zinc-deficiency, as a likely consequence of reduced carbonic anhydrase activity, which is validated by mass spectrometry and immunoblot analysis of Cah1, Cah3 and Cah4. Chlamydomonas is therefore not able to grow photoautotrophically in air in zinc limiting conditions, but supplementation with 1% CO2 restores growth to wild-type rates, suggesting that the inability to maintain CCM is a major consequence of zinc limitation. Surprisingly, we noted also that the Crr1 regulon, which responds to Cu limitation, is also turned on in zinc deficiency, and in fact, Crr1 is required for growth in zinc-limiting conditions. Zinc deficient cells are functionally copper deficient, as evidenced by reduced plastocyanin abundance, even though they hyperaccumulate copper up to 50-fold over normal levels. We suggest that zinc-deficient cells sequester Cu in a bio-unavailable form, perhaps to prevent mis-metallation of critical zinc sites. Zn-limited wild-type cells were generated by transfer of cells from the first round of growth in medium with no supplemental Zn into TAP medium supplemented or not with 2.5 ÂµM Zn-EDTA The control samples for this study are represented in GSE25622

Project description:Background:Inadequate protein intake and hypoalbuminemia, indicators of protein-energy wasting, are among the strongest mortality predictors in hemodialysis patients. Hemodialysis patients are frequently counseled on dietary phosphorus restriction, which may inadvertently lead to decreased protein intake. We hypothesized that, in hypoalbuminemic hemodialysis patients, provision of high-protein meals during hemodialysis combined with a potent phosphorus binder increases serum albumin without raising phosphorus levels. Methods:We conducted a randomized controlled trial in 110 adults undergoing thrice-weekly hemodialysis with serum albumin <4.0 g/dL recruited between July 2010 and October 2011 from eight Southern California dialysis units. Patients were randomly assigned to receive high-protein (50-55 g) meals during dialysis, providing 400-500 mg phosphorus, combined with lanthanum carbonate versus low-protein (<1 g) meals during dialysis, providing <20 mg phosphorus. Prescribed nonlanthanum phosphorus binders were continued over an 8-week period. The primary composite outcome was a rise in serum albumin of ?0.2 g/dL while maintaining phosphorus between 3.5-<5.5 mg/dL. Secondary outcomes included achievement of the primary outcome's individual endpoints and changes in mineral and bone disease and inflammatory markers. Results:Among 106 participants who satisfied the trial entrance criteria, 27% ( n = 15) and 12% ( n = 6) of patients in the high-protein versus low-protein hemodialysis meal groups, respectively, achieved the primary outcome (intention-to-treat P-value = 0.045). A lower proportion of patients in the high-protein versus low-protein intake groups experienced a meaningful rise in interleukin-6 levels: 9% versus 31%, respectively (P = 0.009). No serious adverse events were observed. Conclusion:In hypoalbuminemic hemodialysis patients, high-protein meals during dialysis combined with lanthanum carbonate are safe and increase serum albumin while controlling phosphorus.

Dataset Information

Zinc Burden Evokes Copper Deficiency in the Hypoalbuminemic Hemodialysis Patients.

Publications

Zinc Burden Evokes Copper Deficiency in the Hypoalbuminemic Hemodialysis Patients.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets