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      Long-Term Changes of Plasma Trace Element Concentrations in Chronic Hemodialysis Patients

      a , b

      Blood Purification

      S. Karger AG

      Hemodialysis, long-term, Plasma, Trace elements

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          Background: Hemodialysis (HD) patients are at risk of developing trace element imbalances. Methods: The 12 trace elements Cd, Co, Cs, Cu, La, Mg, Mo, Pb, Rb, Sr, Tl and Zn were determined in the plasma (n = 52) of 6 chronic HD patients before and after HD sessions by inductively coupled plasma mass spectrometry. Plasma trace element concentrations were monitored for 6 months. Baseline data have been compared to the concentrations at the end of the observation period to identify a potential reduction or accumulation of trace elements in HD patients. Results: Plasma Cd, Co and Pb levels were about 10 times higher than in healthy adults. Concentrations of Co and Pb increased during HD sessions, whereas plasma Co and Cd increased during the study period of 6 months. Plasma Cs, Mg, Mo and Rb continuously decreased in all patients. For plasma Cu and Zn, a statistically significant rise of their plasma concentrations during HD and during the period of 6 months could be established. Concentrations of La and Tl did not change distinctly. Conclusion: This study revealed that plasma trace element concentrations in HD patients are distinctly different compared to that of healthy adults. Elements such as Cs, Mg, Mo and Rb are reduced and Cd, Co and Pb are accumulated in HD patients. Further studies are needed to elucidate the clinical impact of these trace element imbalances.

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

          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.

            Author and article information

            Blood Purif
            Blood Purification
            S. Karger AG
            03 August 2000
            : 18
            : 2
            : 138-143
            aInstitute for Analytical Chemistry and bDepartment of Internal Medicine, Division of Nephrology, Karl-Franz University, Graz, Austria
            14437 Blood Purif 2000;18:138–143
            © 2000 S. Karger AG, Basel

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            Page count
            Tables: 3, References: 28, Pages: 6
            Self URI (application/pdf): https://www.karger.com/Article/Pdf/14437
            Original Paper

            Cardiovascular Medicine, Nephrology

            Trace elements, Plasma, Hemodialysis, long-term


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