Zinc tolerance test in uremia: effect of calcitriol supplementation

The effect of 1,25(OH)2D3 on zinc absorption was indirectly determined in hemodialysis patients using the oral zinc tolerance test. The increment in plasma zinc and the area under the curve following an oral zinc load of 25 mg were studied in seven patients, before and after 6 weeks of therapy with 1 microgram/day of 1,25(OH)2D3 [Rocaltrol(R)]. Before therapy, fasting plasma zinc, 2 hour plasma zinc, and the area under the curve (AUC) were subnormal (hemodialysis patients vs normals: 96 +/- 2 vs 105 +/- 3 micrograms/dl, p less than 0.05, 161 +/- 8 vs 222 +/- 16 micrograms/dl, p less than 0.025, and 188 +/- 25 vs 302 +/- 33 micrograms hr/dl, p less than 0.025, respectively). Following Rocaltrol, serum calcium level increased (8.9 +/- .12 to 9.8 +/- .4 mg/dl, p less than 0.05), parathyroid hormone levels decreased (20.4 +/- 8.9 to 13.6 +/- 7.2 ng/ml, p less than 0.05), but there was no significant change in fasting plasma zinc, 2 hour plasma zinc, or AUC (89 +/- 3 micrograms/dl, 149 micrograms/dl, and 176 +/- 18 micrograms hr/dl, respectively). These results suggest that short-term 1,25(OH)2D3 therapy had no significant impact on zinc absorption or plasma zinc level in uremics.