Low Serum Zinc Level May be Related to Higher Doses of EPO in Hemodialysis Patients

Introduction. Anemia is a complication of chronic renal failure observed in patients on hemodialysis (HD) affecting morbidity and mortality of these patients. It is associated with erythropoietin (EPO) deficiency and can be treated by human recombinant erythropoietin (hrEPO). Iron deficiency has been reported as the first line cause for inadequate response to this treatment. Zinc deficiency in hemodialysis (HD) patients was previously reported and the relationship between iron and zinc deficiencies has been known for years. The aim of this study was to find out the relationship between serum zinc level, anemia and rhEPO consuming in HD patients. Methods. A total of 69 HD patients and 34 healthy individuals were included in the study. Serum zinc levels, clinical, hematologic, biochemical parameters and rhEPO doses were evaluated. Results. Serum zinc levels were found to be lower in HD patients in comparison to those in the control group (29.92±12.94, 44.82±27.69 g/dL, respectively) (p<0.001). There was a positive correlation between serum zinc and hemoglobin (Hb) in the control group (R=0.06). In HD patients who needed less then 8000U/week rhEPO, Hb levels (p<0.05) and serum zinc levels were higher. Serum zinc and Hb levels were found to be higher in patients who were under HD treatment for more than 12 months (10.05±1.06 vs 10.69±1.29; p=0.022 and 26.96±13.29 vs 30.88±12.61; p=0.178). Conclusions. HD patients who needed lower dose of EPO had higher serum zinc levels. Although the difference was not statistically significant, these results provide evidence that serum zinc level should be taken into consideration especially in HD patients resistant to EPO therapy.