Disturbances of trace element metabolism in ESRD patients receiving hemodialysis and hemodiafiltration.
BACKGROUND
Accumulation of trace elements occurs in conditions of decreased kidney function. In some conditions, increased trace elements can have toxic features. On the other hand, studies are showing that concentration of some trace elements could be decreased in ERSD patients as well. The most important factor affecting trace element concentration in ERSD patients is the degree of renal failure and the usage of replacement therapy.


METHODS
We analyzed the trace elements' (boron, aluminum, vanadium, chromium, manganese, cobalt, nickel, copper, zinc, arsenic, selenium, rubidium, strontium, cadmium, cesium, barium and lead) concentration in the whole blood of 41 ESRD patients who were treated with hemodialysis and hemodiafiltration and also of 61 healthy blood donors. In addition, comparison of trace element blood levels of patients receiving hemodialysis and hemofiltration was carried out. Whole blood trace element concentration was determined using inductive coupled plasma mass-spectrometry (ICPMS).


RESULTS
Levels of boron, aluminum, vanadium, chromium, manganese, zinc, strontium, cadmium, barium and lead were significantly increased in ESRD patients. Significantly decreased levels were observed for nickel, arsenic, selenium and rubidium. Blood levels of cobalt, copper, cadmium and lead in hemodialysis patients were significantly higher compared to patients receiving hemodiafiltration.


CONCLUSIONS
ESRD is accompanied with serious and multidirectional changes of trace element blood levels. The highest degree of blood level increases were observed for nonessential and toxic trace elements. Disorders of essential trace elements were manifested in a minor degree. Besides this, there were observed differences of trace element concentrations between ESRD patients receiving hemodialysis and hemo-diafiltration.
Medved's Research Center of Preventive Toxicology, Food and Chemical Safety, Ministry of Health Ukraine, Kyiv, Ukraine.
Mykola
M
Prodanchuk
Medved's Research Center of Preventive Toxicology, Food and Chemical Safety, Ministry of Health Ukraine, Kyiv, Ukraine.
Oleksii
O
Makarov
Medved's Research Center of Preventive Toxicology, Food and Chemical Safety, Ministry of Health Ukraine, Kyiv, Ukraine.
Evegnii
E
Pisarev
Centre for Clinical Toxicology of National Child Specialized Clinic "Ohmatdyt" Ministry of Health, Ukraine, Kyiv, Ukraine.
Boris
B
Sheiman
Institute of Nephrology at the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine.
Mykola
M
Kulyzkiy
end stage renal disease; hemodiafiltration; hemodyalisis; trace elements