Introduction

Patients with end-stage renal disease undergoing hemodialysis therapy are at risk of developing deficiencies of essential trace elements and/or overload of toxic trace elements, both of which may significantly affect their clinical status of. Those imbalances may result from the disease itself but also from the quality of the therapeutic process, namely the hemodialysis process, which has greatly evolved in the last decades. Thus, old observations that have been assumed as very well-proven have been recently questioned. In this case-control study we evaluate the current trace elements status in a group of Portuguese patients under hemodialysis therapy.

Material and methods

Serum samples from patients (n = 93), collected for the routine periodic control of Al levels, were analyzed for a wide panel of trace elements (Li, Al, Mn, Co, Ni, Cu, Zn, Se, Rb, Sr, Mo, Cd, Ba, Pb) using inductively coupled plasma mass spectrometry technique (hemodialysis patients’ group). For comparison purposes, samples of individuals with no evidence of renal disease according to standard laboratory analytical criteria (n = 50) were also analyzed (control group).

Results

The results showed significant differences between the two groups, with higher values in hemodialysis patients group for Al (14.6 vs. 9.5 μg/L), Co, Ni, Sr, Mo (4.5 vs. 1.4 μg/L), Cd (0.058 vs. 0.025 μg/L) and Pb (0.55 vs. 0.30 μg/L); and lower values in hemodialysis patients group for Li (4.0 vs. 75.8 μg/L), Mn, Cu (943.5 vs. 1038.5 μg/L), Zn (943.5 vs. 1038.5 μg/L), Se (71.5 vs. 103.8 μg/L), Rb (202.4 vs. 300.3 μg/L) and Ba (0.65 vs. 8.7 μg/L).

Conclusion

This study confirms that hemodialysis patients tend to present significant trace elements imbalances, which may be related to the higher morbidity and mortality observed in this specific patients’ group.

中文翻译：

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接受慢性血液透析治疗的患者的微量元素失衡 - 葡萄牙患者队列的观察性研究报告。

简介

接受血液透析治疗的终末期肾病患者有发生必需微量元素缺乏和/或有毒微量元素过载的风险，这两种情况都可能显着影响其临床状态。这些不平衡可能源于疾病本身，也可能源于治疗过程的质量，即血液透析过程，该过程在过去几十年中得到了极大的发展。因此，被认为已经得到充分证明的旧观察结果最近受到了质疑。在这项病例对照研究中，我们评估了一组接受血液透析治疗的葡萄牙患者的当前微量元素状态。

材料和方法

为定期定期控制铝水平而收集的患者血清样本 (n = 93) 分析了多种微量元素（Li、Al、Mn、Co、Ni、Cu、Zn、Se、Rb、Sr、 Mo, Cd, Ba, Pb) 使用电感耦合等离子体质谱技术（血液透析患者组）。为了比较，还分析了根据标准实验室分析标准（n = 50）没有肾病证据的个体样本（对照组）。

结果

结果显示两组之间存在显着差异，血液透析患者组的 Al（14.6对9.5 μg/L）、Co、Ni、Sr、Mo（4.5对1.4 μg/L）、Cd（0.058对9.5 μg/L）、Cd（0.058对. 0.025 微克/升）和铅（0.55与0.30 微克/升）；血液透析患者组中锂（4.0对75.8 微克/升）、锰、铜（943.5对1038.5 微克/升）、锌（943.5对1038.5 微克/升）、硒（71.5对103.8 微克/升）的较低值/L)、Rb（202.4对300.3 μg/L）和 Ba（0.65对8.7 μg/L）。

结论

该研究证实，血液透析患者往往存在显着的微量元素失衡，这可能与在该特定患者组中观察到的较高发病率和死亡率有关。