In order to assess the alterations in the blood and tissue levels of the various trace elements in the patients with chronic renal failure, plasma and red blood cell concentrations of the zinc, copper and lead were measured in the pre-dialysis uremic patients (n=24), patients undergoing chronic hemo-dialysis (n=27) and continuous ambulatory peritoneal dialysis (n=14). Also, to seek any effects of the parathyroid hormone (PTH) which is uniformly elevated and believed to be one of the uremic toxins on the trace elements alteration, PTH levels were measured and compared to trace elements concentration.
1) Plasma zine concentration of the uremic(12.8
2.9pmoles/1), hemodialysis (13.1±1.8proles/1) and CAPD (13.2~-2.8pmoles/1) patients were all reduced significantly compared to the concentration of the normal persons (17.512.5pmoles/1). No significant differences were noted between the uremic and dialysis patients.
2) Red cell zinc concentrations were significantly higher(p<0.01) in the predialysis 216±40.5umoles/1) and hemodialysis (217.3±26.9pmoles/1) patient compared to the normal control (176128.8pmoles/I). The patients undergoing CAPD tended to have lower red cell zinc level compared to the predialysis uremic patients.
3) Plasma copper concentrations of the patients´ with chronic renal failure both in the pre-dialysis and dialysis patients were not significantly diffe rent from the plasma copper level of the normal control subjects (16.5=3.3pmoles/1). However, red cell copper were significantly reduced in the he-modialysis (15.4-´-2.5pmoles/1) and CAPD(15.1 3.2umoles/1) patients compared to the normal anduremic persons(19.1+2.7pmoles/1).
4) Patients with chronic renal failure regardless of their dialysis status revealed significantly hig her red cell lead concentration compared to the normal subjects.
5) Mean serum concentrations of the parathyroid hormone measured by the C-terminal radioimmunoassay method were markedly elevated in the all renal failure patient groups, the highest being observed in the hemodialysis patients.
6) The concentrations of the plasma zinc and -the red cell zinc, copper and lead, all of which revealed significant changes compared to the concentrations observed in the normal subjects showed no evident correlation when plotted against the individual parathyroid hormone levels, thus suggesting that PTH does not play a major role in the trace elements alterations.
7) Further evaluations are needed to assess the long-term changes of the various trace elements and the clinical consequences of these changes in these patients, particularly those undergoing long term chronic peritoneal dialysis.
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