Serum Level of Trace Elements in Pediatric Patients with End Stage Renal Disease on Hemodialysis

Abstract

Background: Chronic kidney disease (CKD) represents a significant global health challenge with rising rates that may herald a  widespread epidemic.

Objective: This study aimed to evaluate the serum concentrations of copper (Cu), zinc (Zn), selenium (Se), and lead  (Pb) in children with end-stage renal disease (ESRD) undergoing long-term hemodialysis.

Patients and methods: Conducted as a  case-control study, we included 200 children divided equally into two groups. Group A consisted of children with ESRD, exhibiting a  glomerular filtration rate (GFR) of less than 10 mL/min/1.73 m², and undergoing regular hemodialysis 2-3 times per week for 3-4 hours  per session, sustained for more than six months. Group B comprised healthy children with normal baseline levels of blood urea nitrogen  (BUN), creatinine, aspartate aminotransferase (AST), and alanine transaminase (ALT), confirmed through routine clinical visits, medical  history, and examinations.

Results: Lead levels showed a positive correlation with the duration of dialysis and a negative correlation with  weight and BMI. Zinc levels demonstrated a negative correlation with the duration of dialysis and a positive correlation with weight, height, and BMI. Compared to the control group, children with CKD had significantly higher levels of potassium and phosphorus and  lower levels of calcium.

Conclusion: Children with ESRD on regular hemodialysis exhibited decreased serum levels of Cu and Zn, while Pb  levels increased, with no significant changes in Se levels. Serum Pb and Zn levels were associated with the duration of hemodialysis, and  Zn levels also correlated with anthropometric measurements.