Pre-dialysis serum creatinine as an independent predictor of responsiveness to zinc supplementation among patients on hemodialysis

Clin Exp Nephrol. 2020 Oct;24(10):955-962. doi: 10.1007/s10157-020-01911-x. Epub 2020 Jun 15.

Abstract

Background: To investigate whether pre-dialysis level of serum creatinine (SCre) could indicate the responsiveness to zinc supplementation of patients on maintenance hemodialysis (MHD).

Methods: We retrospectively reviewed the results of our previous randomized study of 91 patients who had been on MHD and received zinc supplementation with either zinc acetate hydrate (ZAH; zinc, 50 mg/day) or polaprezinc (PPZ; zinc, 34 mg/day). A late response to zinc supplementation was defined as a serum zinc level of < 80 μg/dL three months after the study began. Patients were divided into two groups: late response (serum zinc level < 80 μg/dL) and early response (serum zinc level ≥ 80 μg/dL). Factors independently associated with a late response to zinc supplementation were determined using inverse probability of treatment weighting (IPTW) multivariate logistic analysis.

Results: Of 91 patients, 86 continued to receive zinc supplementation after three months. The mean pre-dialysis SCre level was 10.0 mg/dL. The number of patients with a late response and response to zinc supplementation was 32 and 54, respectively. There was a significant negative correlation between the pre-dialysis SCre and the Δserum zinc change for 3 months. (r = - 0.284, P = 0.008). IPTW multivariate analysis showed that a pre-dialysis SCre level ≥ 10.0 mg/dL (odds ratio, 3.71; 95% confidence interval; 1.24-11.1, P = 0.022) was an independent factor associated with a late response to zinc supplementation.

Conclusions: Pre-dialysis SCre level was independently associated with responsiveness to zinc supplementation after three months in patients on MHD.

Keywords: Hemodialysis; Predictor; Responsiveness; Serum creatinine; Zinc supplementation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Aged
  • Aged, 80 and over
  • Anti-Ulcer Agents / administration & dosage
  • Carnosine / administration & dosage
  • Carnosine / analogs & derivatives*
  • Creatinine / blood*
  • Dietary Supplements
  • Female
  • Humans
  • Kidney Failure, Chronic / blood*
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Organometallic Compounds / administration & dosage*
  • Renal Dialysis
  • Retrospective Studies
  • Time Factors
  • Zinc / blood
  • Zinc / deficiency
  • Zinc Acetate / administration & dosage*
  • Zinc Compounds / administration & dosage

Substances

  • Anti-Ulcer Agents
  • Organometallic Compounds
  • Zinc Compounds
  • polaprezinc
  • Carnosine
  • Creatinine
  • Zinc Acetate
  • Zinc