Zinc deficiency anemia and effects of zinc therapy in maintenance hemodialysis patients.
Quantitative adjuvant zinc therapy using polaprezinc was performed to examine the correlation between zinc concentration and anemia in maintenance hemodialysis patients to propose appropriate treatment. Anemia and serum zinc concentration were measured in 117 patients with chronic renal failure receiving outpatient maintenance hemodialysis at Tsuyama Chuo Kinen Hospital. Two bags of polaprezinc (containing zinc 34 mg/day) were administered to 58 patients with lower than normal zinc levels (Zn < 80 mg/dl) as adjuvant zinc therapy to assess anemia improvement. Zinc concentration and all anemia parameters showed significant positive correlation, indicating that anemia improves in patients with high serum zinc levels. Regarding the effects of adjuvant zinc therapy for improving anemia, hemoglobin levels were found to increase significantly to the highest value at 3 weeks. During treatment, the dosage of erythropoietin was reduced significantly from baseline at all assessment points. No zinc poisoning from therapy was seen, but two patients had diarrhea (1.9%). Zinc-treated patients required iron therapy due to the development of iron deficiency. Most maintenance hemodialysis patients suffer from zinc deficiency anemia, and zinc-based polaprezinc has been confirmed to be an effective and safe adjuvant zinc treatment. Most patients diagnosed as refractory anemia with no response to erythropoietin also suffer from zinc deficiency anemia, many of whom are expected to benefit from zinc therapy to improve their anemia. Possible zinc deficiency anemia should be considered in the treatment of refractory anemia with no response to erythropoietin.
Fukushima
Tatsuo
T
Department of Medicine, Tsuoyama Chuo Hospital, 71 Nikaimachi, Tsuyama, Okayama, Japan. fuku@tch.or.jp
Horike
Hideyuki
H
Fujiki
Shigeatsu
S
Kitada
Shingo
S
Sasaki
Tamaki
T
Kashihara
Naoki
N
D000368:Aged; D000740:Anemia / Q000188:drug therapy* / Q000209:etiology; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy / Q000209:etiology; D002336:Carnosine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003967:Diarrhea / Q000139:chemically induced; D004305:Dose-Response Relationship, Drug; D004921:Erythropoietin / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D058085:Iron Compounds / Q000008:administration & dosage; D007564:Japan / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D011994:Recombinant Proteins; D006435:Renal Dialysis / Q000009:adverse effects*; D015032:Zinc / Q000097:blood / Q000172:deficiency; D017967:Zinc Compounds / Q000009:adverse effects / Q000627:therapeutic use
D006454:Hemoglobins; D058085:Iron Compounds; D009942:Organometallic Compounds; D011994:Recombinant Proteins; D017967:Zinc Compounds; C061957:polaprezinc; D004921:Erythropoietin; D002336:Carnosine; D015032:Zinc