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Elevated plasma copper in chronic renal failure.

J H Sondheimer1, S K Mahajan, D L Rye

  • 1Department of Medicine, Wayne State University School of Medicine, Detroit, MI 48201.

The American Journal of Clinical Nutrition
|May 1, 1988
PubMed
Summary
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Plasma copper levels are elevated in patients with chronic kidney disease, whether on dialysis or not. This increase in copper is not due to higher ceruloplasmin levels, indicating a different underlying mechanism in uremia.

Area of Science:

  • Nephrology
  • Biochemistry
  • Trace Element Metabolism

Background:

  • Hypercupremia, or elevated plasma copper, is observed in patients undergoing chronic dialysis.
  • Understanding the specific mechanisms behind copper dysregulation in uremia is crucial for patient management.

Purpose of the Study:

  • To investigate plasma copper (PCu) and ceruloplasmin (Cp) levels in patients with varying stages of chronic kidney disease.
  • To differentiate between dialysis-associated and non-dialysis-associated hypercupremia in uremic patients.

Main Methods:

  • Studied plasma copper and ceruloplasmin in hemodialysis patients, peritoneal dialysis patients, pre-dialysis uremic patients, and healthy controls.
  • Measured non-ceruloplasmin copper and chelatable copper to assess copper distribution and availability.

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Main Results:

  • All patient groups (hemodialysis, peritoneal dialysis, pre-dialysis uremia) exhibited significantly elevated plasma copper compared to controls.
  • Plasma ceruloplasmin levels did not differ significantly across the study groups.
  • Calculated non-ceruloplasmin copper and measured chelatable copper were significantly higher in all uremic patient groups compared to controls.

Conclusions:

  • Copper levels are elevated in uremia irrespective of dialysis treatment.
  • The observed hypercupremia in uremia is not attributable to increased plasma ceruloplasmin.
  • The findings suggest an alternative mechanism for copper elevation in uremic patients.