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      Exchange of Alkali Trace Elements in Hemodialysis Patients:A Comparison with Na + and K +

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          Background: In the past, nephrologists have been troubled by electrolyte disturbances and consequently focused their attention on the importance of maintaining the concentrations of electrolytes within the normal range. However, information about the potential role of trace elements in chronic renal failure is scarce. Methods: During hemodialysis sessions, the concentrations of the five alkali metal cations lithium (Li), sodium (Na), potassium (K), rubidium (Rb), and cesium (Cs) have been determined in plasma and dialysis fluids of chronic hemodialysis patients by inductively coupled plasma mass spectrometry (Li, Rb, Cs) and by ion-sensitive electrodes (Na, K). Strict quality control schemes were applied to all analytical procedures to ensure accuracy and precision of the results. Results: The plasma concentrations of the elements Li, Cs, Rb, and K distinctly decreased to 29, 50, 69, and 71%, respectively, of their initial values during hemodialysis. Simultaneously, the concentrations of these elements in dialysis fluids at the outlet of the dialyzer increased approximately 13-fold for Rb, 11-fold for Li, 3-fold for Cs, and 2-fold for K as compared with the inlet values. The concentrations of Na in plasma and dialysis fluids were almost identical and did not change during hemodialysis. Conclusions: Li, Rb, and Cs were depleted in hemodialysis patients, although the plasma concentrations of these trace elements still remained within the reference ranges for healthy adults. Consequently, further studies are needed to elucidate the clinical importance and long-term effects of these trace element imbalances – for example, CNS disturbances associated with diminished concentrations of Rb – in hemodialysis patients.

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          Trace element reference values in tissues from inhabitants of the European community I. A study of 46 elements in urine, blood and serum of Italian subjects

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            Certification of a second-generation biological reference material (freeze-dried human serum) for trace element determinations


              Author and article information

              S. Karger AG
              November 1999
              13 October 1999
              : 83
              : 3
              : 226-236
              aInstitute of Analytical Chemistry and bDepartment of Internal Medicine, Medical School, Karl Franzens University, Graz, cInstitute of Biomedical Engineering, Technical University, Graz, Austria
              45515 Nephron 1999;83:226–236
              © 1999 S. Karger AG, Basel

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              Page count
              Figures: 2, Tables: 5, References: 45, Pages: 11
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              Original Paper

              Cardiovascular Medicine, Nephrology

              Plasma, Dialysis fluids, Lithium, Sodium, Cesium, Potassium, Rubidium, Hemodialysis


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