EFFICACY OF ZINC SUPPLEMENTATION ON IMPROVEMENT OF THE ANEMIA AND OXIDATIVE STRESS IN HEMODIALYSIS PATIENTS.

Anemia is a major complication in patients on chronic dialysis. In renal diseases, changes in the trace elements metabolism may influence the equilibrium in the antioxidant defense system and enhance the toxic effects of the reactive oxygen species that may have a role in anemia of dialysis patients. On the other hand, trace elements including zinc are part of antioxidant enzymes such as superoxide dismutase and glutathione peroxidase (SOD). The aim of the present study was to evaluate the efficacy of zinc supplementation on the improvement of the anemia and also oxidative stress of hemodialysis patients.

Materials & Methods : 42 hemodialysis patients were enrolled in this randomized clinical trial. After an informed consent, the patients were randomized into two groups group 1 (n=22) received erythropoietin 4000 U/week (EPREX, CILAG AG international, Switzerland) and zinc sulfate 220mg (50 mg/day zinc) for three months group 2 (n=20) was on erythropoietin alone at the same dose of group 1. All the patients were otherwise on a comparable drug chart. Serum zinc level was measured using atomic absorption spectrophotometry before zinc supplementation and at the end of the study. Hb and Hct were measured before and monthly for 3 months thereafter zinc administration. Malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase, total antioxidant status (TAS) and high sensitive CRP were determined by standard methods at the end of study. Statistical analysis was performed using SPSS (t test) and P-value < 0.05 was considered significant.

Results: Both groups were comparable regarding the age and gender of the patients. Mean serum zinc level was 85 +/- 15.8l that rose to 218 +/- 16.8 after zinc supplementation (P < 0.01). Mean Hb and Hct were elevated significantly in zinc supplemented patients at the end of study (P < 0.05). There was no significant difference in total antioxidant, MDA, GPX, SOD, cholesterol, triglyceride and high sensitive CRP level between zinc supplemented and control patients

Conclusion : O ur study showed that zinc supplementation result in significant improvement of the anemia with Hb and Hct rising in hemodialysis patients. We couldn’t find any significant changes in oxidative stress markers with zinc supplementation during the study