Serum levels of zinc, copper and magnesium in end stage renal disease subjects and their clinical and biochemical correlations

Abnormalities of zinc, copper and magnesium are well documented in uremia and dialysis. They have potential role in the pathogenesis of uremic manifestations and may have therapeutic significance. Therefore, this study was undertaken to estimate serum level of zinc, copper and magnesium in dialyzed and non-dialyzed ESRD subjects and to correlate these with clinical and biochemical parameters. Forty healthy controls (M21, F19), 20 ESRD subjects on hemodialysis (group I) and 20 non-dialyzed ESRD subjects (group - II) were included. Trace metals were estimated by Atomic absorption spectrophotometry. Mean ± SD serum zinc in group I was similar to controls (88.35 ± 30.6 V 88.10± 19.0 mcg/dl, p NS), while group II had lower serum zinc than controls (68.20±22.2 V 85.10±19.0 P<0.001). Mean serum copper in group I (119.55 ± 26.28 mcg/dl) and group II (109.45±21.38) were not significantly different from controls (108.70±31.35). Mean serum magnesium was significantly higher in group I (3.85±1.38 mg/dl) and group II (3.32±0.98) subjects than controls (2.03±0.30). Serum zinc had positive correlation with serum protein (r + 0.78, p <0.001) and hemoglobin level (r + 0.56, p <0.001) and negative correlation with urinary protein excretion (r = 016, p NS). Serum copper had positive correlation with hemoglobin level (r + 0.56, p <0.001) and negative correlation with urinary protein excretion (r- 0.16, p NS). Serum copper had positive correlation with hemoglobin level (r+0.91, p <0.001). Serum magnesium had negative correlation with creatinine clearance rates (r-0.53, P<0.001). Significantly larger number of group II patients were anorexic (75% V 40%, p <0.02). No significant difference was seen between two groups in frequency of hypogeusia, sexual dysfunction and grade of muscle strength. In conclusion, non-dialyzed ESRD subjects were hypozincemic while young and adequately dialyzed subjects with normal serum protein had normal serum zinc. Hypozincemia was found to be etiologically related to anorexia while no such relationship was found with hypogeusia and sexual dysfunction. Serum copper was normal in all ESRD subjects. Zinc and copper had positive correlation with hemoglobin values. Serum magnesium, having negative correlation with creatinine clearance rates was raised in all the patients, however, it was not high enough to produce symptoms or signs.