Trace elements in end-stage renal disease. 2. Clinical implication of trace elements.

Area of Science:

• Biochemistry
• Nephrology
• Human Nutrition

Background:

• Trace elements are essential nutrients crucial for numerous bodily functions, including enzyme activity, immune response, and free radical regulation.
• Uremia and hemodialysis procedures can significantly alter trace element levels in patients with chronic kidney disease.
• The precise role and management of trace elements in hemodialysis patients require further elucidation.

Purpose of the Study:

• To investigate the role and impact of trace elements in patients undergoing hemodialysis.
• To highlight the importance of water treatment in preventing trace element accumulation.
• To evaluate the potential benefits and indications for trace element supplementation in chronic kidney disease patients.

Main Methods:

• Literature review and analysis of existing studies on trace elements in hemodialysis patients.
• Discussion of the impact of water treatment methods, such as reverse osmosis, on trace element levels.
• Evaluation of the evidence for zinc and selenium supplementation in chronic renal failure patients.

Main Results:

• Reverse osmosis water treatment effectively prevents the accumulation of most trace elements in hemodialysis patients.
• Zinc supplementation is only recommended for patients with documented zinc deficiency; its general use is questionable.
• Selenium deficiency is common in dialyzed patients, and supplementation may offer benefits like increased glutathione peroxidase activity, cardioprotection, and immune support.

Conclusions:

• Adequate water treatment is crucial for managing trace element levels in hemodialysis patients.
• Selenium supplementation may be beneficial for chronic renal failure patients due to potential deficiency and positive health effects.
• Trace element supplementation should be guided by documented depletion and evidence of improved quality of life in dialyzed patients.