Zinc Metabolism in Renal Failure

Manifestations of zinc deficiency include abnormal bone metabolism, skin lesions, testicular atrophy, and impaired wound healing. Because these abnormalities are also common in uremia, zinc metabolism in renal insufficiency was studied. Blood, urine, and hair were collected from 42 male subjects, including 10 dialysis patients, 21 nondialyzed uremic patients, and 11 controls. Postmortem tissues (heart, liver, kidney, and testes) from patients who died of uremia were also analyzed. Plasma zinc was below normal in 21 of 31 patients. The zinc content of hair, heart, liver, and testes was normal. To measure the effect of acute uremia on zinc metabolism plasma zinc in rats was measured 24 hr after ureteral ligation. Despite low plasma zinc levels, there was no tissue deficit of zinc in hair, heart, liver, or testes of patients with chronic renal failure. Decreased plasma zinc can be demonstrated experimentally in uremic rats in the absence of zinc deficiency. Decreased plasma zinc in renal insufficiency may be due to redistribution rather than to total body deficiency.