SERUM TRACE ELEMENTS IN CHILDREN ON MAINTENANCE HEMODIALYSIS

During dialysis some trace elements can accumulate while others may be removed from blood, leading to deficiency of some trace elements. For evaluating changes of serum trace elements in children on maintenance hemodialysis we measured copper (Cu), zinc (Zn), cobalt (Co), manganese (Mn), chromium (Cr) and nickel (Ni) in 3 groups of children: Group 1, children with CRF who were on regular hemodialysis; Group 2, children with CRF who were on conservative management, and Group 3, healthy children. For evaluating the impact of duration of dialysis on serum trace elements, group 1 patients were divided into two subgroups: A, patients who were on hemodialysis therapy for shorter than 18 months, and B, patients who were on hemodialysis therapy for longer than 18 months. The technique used for measurement of trace elements was PIXE (Proton Induced X-ray Emission). Mean serum levels of Zn, Mn, and Ni in group 1 were lower than group 2 and group 3. There were not significant differences in serum levels of Zn, Mn and Ni between group 2 and 3. The differences in serum levels of Cr, Co and Cu among 3 groups were not significant. The serum levels of Zn, Mn and Ni were significantly lower in subgroup B compared to subgroup A. Correlation test showed that there were an inverse linear relation between the period of hemodialysis and serum levels of Zn, Mn and Ni. Chronic hemodialysis leads to abnormalities of some trace elements in children, and these derangements increase with duration of hemodialysis.