Zinc deficiency: a reversible complication of uremia

doi:10.1093/ajcn/36.6.1177

The American Journal of Clinical Nutrition

Volume 36, Issue 6, December 1982, Pages 1177-1183

https://doi.org/10.1093/ajcn/36.6.1177 Get rights and content

ABSTRACT

Subnormal plasma zinc levels and decreased zinc concentration in hair and leucocytes as well as increased plasma ammonia and ribonuclease activity in dialyzed and nondialyzed uremic patients indicate that zinc metabolism is abnormal in uremia and is not corrected by dialysis. The effect of oral supplementation with zinc acetate (12 patients) or placebo (12 patients) on the above biochemical parameters in hemodialysis patients was determined as a part of a double-blind study. The zinc-supplemented, but not the placebo, group demonstrated significant increases in mean (± SD), plasma zinc (80 ± 9 to 110 ± 14, μg/dl), leucocyte zinc (56 ± 13 to 109 ± 18, μg/10¹⁰ cells), hair zinc (140 ± 12 to 190 ± 16 μg/g), and decreases in plasma ammonia (76 ± 10 to 40 ± 6 μg/dl) and plasma ribonuclease activity (1.49 ± 0.08 to 0.78 ± 0.10, OD/min/ml). Abnormalities of taste and sexual function improved significantly in patients receiving zinc but not in those on placebo therapy. These improvements in biochemical as well as clinical parameters confirm and extend our earlier observations of improvement in taste and sexual function after zinc supplementation. Together, they suggest that zinc deficiency is a complicating feature of uremia and can be corrected by oral zinc supplementation.

References (28)

SekineH et al.
Interaction of DNA with pancreatic ribonuclease.
A Biochem Biophys Acta
(1969)
MahajanSK et al.
Improvement of uremic hypogeusia by zinc: a double blind study.
Am J Clin Nutr
(1980)
RothsteinG et al.
A method for leukokinetic study in the non-steady state.
Blood
(1971)
SandsteadHH et al.
Human zinc deficiency, endocrine menifestation and response to treatment.
Am J Clin Nutr
(1967)
HalstedJA et al.
Zinc deficiency in man. The Shiraz experiment.
Am J Med
(1972)
BeiselWR et al.
Acute stress and trace dc- ment metabolism.
BogdenJD et al.
Elevated plasma zinc concentrations in renal dialysis patients.
Am J Clin Nutr
(1980)
SchreinerGE et al.
Problems ofhemodialysis.
Proc 3rd Int Congr Nephrol
(1967)
CondonCH et al.
Zinc metabolism in renal failure.
Ann intern Med
(1970)
MansouriK et al.
Zinc, copper. magnesium and calcium in dialyzed and non-dialyzed uremic patients.
Arch Intern Med
(1970)

MahlerDJ et al.

Magnesium, zinc, and copper in dialysis patients.

Am J Clin Pathol

(1971)

MahajanSK et al.

Abnormal plasma and erythrocyte zinc distribution in uremia.

Trans Am Soc Artif Intern Organs

(1978)

LindemanRD et al.

Serum concentrations and urinary excretions of zinc in cirrhosis, nephrotic syndrome, and renal insufficiency.

Am J Med Sci

(1978)

CornelisR et al.

Serum and red blood cell Zn, Se, Cs and Rb in dialysis patients.

Mineral Electrolyte Metab

(1979)

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Zinc deficiency: a reversible complication of uremia

ABSTRACT

A Biochem Biophys Acta

Am J Clin Nutr

Blood

Am J Clin Nutr

Am J Med

Am J Clin Nutr

Problems ofhemodialysis.

Proc 3rd Int Congr Nephrol

Zinc metabolism in renal failure.

Ann intern Med

Zinc, copper. magnesium and calcium in dialyzed and non-dialyzed uremic patients.

Arch Intern Med

Magnesium, zinc, and copper in dialysis patients.

Am J Clin Pathol

Abnormal plasma and erythrocyte zinc distribution in uremia.

Trans Am Soc Artif Intern Organs

Serum concentrations and urinary excretions of zinc in cirrhosis, nephrotic syndrome, and renal insufficiency.

Am J Med Sci

Serum and red blood cell Zn, Se, Cs and Rb in dialysis patients.

Mineral Electrolyte Metab