Background Erythropoietin stimulating agent therapy is widely used in hemodialysis (HD) patients to improve quality of life and reduce the need for blood transfusions. Recent studies have demonstrated that zinc deficiency could cause erythropoietin stimulating agent hypo-responsiveness. This research paper aims to review the prevalence of zinc deficiency in end-stage renal disease patients and explore its relationship with anemia and erythropoietin resistance index (ERI). Patients and methods The study was conducted on 42 end-stage renal disease patients who were on maintenance HD. All candidates were subjected to detailed history taking, full physical examination, and routine laboratory investigations including urea reduction ratio, serum iron, total iron binding capacity, serum ferritin, serum albumin and C-reactive protein. Serum Zinc concentrations were measured by flame Atomic Absorption Spectrophotometer. Results The average ERI ranged from 3.70 to 20.40 with a mean of 10.30 ± 4.70. Serum zinc levels ranged between 8.20 and 24.30 ug/dl with a mean of 14.0 ± 3.0 ug/dl, denoting that all patients have severe zinc deficiency. There was no significant correlation between serum zinc and ERI (P = 0.234) as well as between serum zinc and Hb levels (P = 0.263). The mean Hb level was significantly lower in the high ERI group (Hb 9.4 ± 1.1 g/dl) compared with the low ERI group (Hb 10.2 ± 1.2) (P = 0.018). Conclusion Our study emphasizes the need to implement scheduled testing of serum zinc levels in HD patients in the Egyptian population. Even without obvious signs of malnutrition in patients like hypoalbuminemia, they may still suffer from severe zinc deficiency.
Hassan et al. (Sat,) studied this question.