Serum Zinc Concentration and Its Association With Nutritional Status in Hemodialysis Patients: A Cross-Sectional Study

Background: Serum zinc concentrations are frequently reduced in patients with end-stage kidney disease receiving maintenance hemodialysis (MHD), but their association with nutritional status remains unclear.This study primarily examined the relationship between predialysis serum zinc and 7-point Subjective Global Assessment (SGA) scores, with secondary analyses exploring clinical and biochemical correlations and factors associated with serum zinc <60 µg/dL.Methods: This analytical cross-sectional study enrolled 73 adults receiving MHD at a tertiary-care teaching hospital from January to March 2026.Nutritional status was evaluated using the 7-point SGA, and serum zinc was measured in midweek predialysis blood samples.Associations with nutritional, clinical, and biochemical parameters were examined using Spearman's correlation, while factors associated with low serum zinc (<60 µg/dL) were explored using univariable logistic regression.Results: The mean age was 43.62 ± 15.51 years, and 34 patients (46.6%) were females.The mean serum zinc concentration was 51.20 ± 12.61 µg/dL, and 63 patients (86.3%) had low serum zinc (<60 µg/dL).Based on SGA scores, 18 patients (24.7%) were well nourished, 53 (72.6%) had mild-to-moderate malnutrition, and two (2.7%) had severe malnutrition.Serum zinc concentrations did not differ significantly across nutritional status groups (p = 0.243), though the small severe-malnutrition group limited interpretation.Serum zinc was not significantly correlated with SGA score (Spearman's ρ = -0.177;p = 0.135), albumin, high-sensitivity Creactive protein (hs-CRP), BMI, hemoglobin, or dialysis vintage.The correlation between zinc and albumincorrected calcium was nominally significant (ρ = 0.255; p = 0.029) but did not meet the Bonferroni-adjusted significance threshold (p < 0.0038).No variables were significantly associated with low serum zinc (<60 µg/dL) in univariable logistic regression.Conclusions: Low serum zinc concentration (<60 µg/dL) was common, but serum zinc was not significantly associated with SGA-defined nutritional status in this cohort.Future larger studies using standardized zinc sampling and reproducible nutritional assessment methods are needed to determine the association between nutritional status and serum zinc concentrations.