Effect of Zinc Supplementation on Maintenance Hemodialysis Patients: A Systematic Review and Meta-Analysis of 15 Randomized Controlled Trials

Overview

Journal Biomed Res Int

Publisher Wiley

Specialties Biomedical Engineering
Biotechnology
General Medicine

Date 2018 Feb 20

PMID 29457023

Citations 34

Authors

Ling-Jun Wang

Ming-Qing Wang

Rong Hu

Yi Yang

Yu-Sheng Huang

Shao-Xiang Xian

Lu Lu

Affiliations

Soon will be listed here.

Abstract

We aimed to examine the effects of zinc supplementation on nutritional status, lipid profile, and antioxidant and anti-inflammatory therapies in maintenance hemodialysis (MHD) patients. We performed a systematic review and meta-analysis of randomized, controlled clinical trials of zinc supplementation. Metaregression analyses were utilized to determine the cause of discrepancy. Begg and Egger tests were performed to assess publication bias. Subgroup analysis was utilized to investigate the effects of zinc supplementation in certain conditions. In the crude pooled results, we found that zinc supplementation resulted in higher serum zinc levels (weighted mean difference [WMD] = 28.489; < 0.001), higher dietary protein intake (WMD = 8.012; < 0.001), higher superoxide dismutase levels (WMD = 357.568; = 0.001), and lower levels of C-reactive protein (WMD = -8.618; = 0.015) and malondialdehyde (WMD = -1.275; < 0.001). The results showed no differences in lipid profile. In the metaregression analysis, we found that serum zinc levels correlated positively with intervention time ( = 0.272; = 0.042) and varied greatly by ethnicity ( = 0.023). Results from Begg and Egger tests showed that there was no significant bias in our meta-analysis ( > 0.1). Results of subgroup analysis supported the above results. Our analysis shows that zinc supplementation may benefit the nutritional status of MHD patients and show a time-effect relationship.

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References

Bao B, Prasad A, Beck F, Fitzgerald J, Snell D, Bao G . Zinc decreases C-reactive protein, lipid peroxidation, and inflammatory cytokines in elderly subjects: a potential implication of zinc as an atheroprotective agent. Am J Clin Nutr. 2010; 91(6):1634-41. PMC: 2869512. DOI: 10.3945/ajcn.2009.28836. View

Ghasemi A, Zahediasl S, Hosseini-Esfahani F, Azizi F . Reference values for serum zinc concentration and prevalence of zinc deficiency in adult Iranian subjects. Biol Trace Elem Res. 2012; 149(3):307-14. DOI: 10.1007/s12011-012-9445-2. View

Zhu K, Nie S, Li C, Huang J, Hu X, Li W . Antidiabetic and pancreas-protective effects of zinc threoninate chelate in diabetic rats may be associated with its antioxidative stress ability. Biol Trace Elem Res. 2013; 153(1-3):291-8. DOI: 10.1007/s12011-013-9675-y. View

Chevalier C, Liepa G, Murphy M, Suneson J, Vanbeber A, Gorman M . The effects of zinc supplementation on serum zinc and cholesterol concentrations in hemodialysis patients. J Ren Nutr. 2002; 12(3):183-9. DOI: 10.1053/jren.2002.33515. View

Wessells K, Brown K . Estimating the global prevalence of zinc deficiency: results based on zinc availability in national food supplies and the prevalence of stunting. PLoS One. 2012; 7(11):e50568. PMC: 3510072. DOI: 10.1371/journal.pone.0050568. View

Kimmel P, Langman C, Bognar B, Faugere M, Chawla L, Watkins D . Zinc nutritional status modifies renal osteodystrophy in uremic rats. Clin Nephrol. 2002; 56(6):445-58. View

Dashti-Khavidaki S, Khalili H, Vahedi S, Lessan-Pezeshki M . Serum zinc concentrations in patients on maintenance hemodialysis and its relationship with anemia, parathyroid hormone concentrations and pruritus severity. Saudi J Kidney Dis Transpl. 2010; 21(4):641-5. View

Rogalska J, Brzoska M, Roszczenko A, Moniuszko-Jakoniuk J . Enhanced zinc consumption prevents cadmium-induced alterations in lipid metabolism in male rats. Chem Biol Interact. 2008; 177(2):142-52. DOI: 10.1016/j.cbi.2008.09.011. View

Muirhead N, Kertesz A, Flanagan P, Hodsman A, Hollomby D, VALBERG L . Zinc metabolism in patients on maintenance hemodialysis. Am J Nephrol. 1986; 6(6):422-6. DOI: 10.1159/000167247. View

10.

Lobo J, Torres J, Fouque D, Mafra D . Zinc deficiency in chronic kidney disease: is there a relationship with adipose tissue and atherosclerosis?. Biol Trace Elem Res. 2009; 135(1-3):16-21. DOI: 10.1007/s12011-009-8504-9. View

11.

Turk S, Bozfakioglu S, Ecder S, Kahraman T, Gurel N, Erkoc R . Effects of zinc supplementation on the immune system and on antibody response to multivalent influenza vaccine in hemodialysis patients. Int J Artif Organs. 1998; 21(5):274-8. View

12.

Rashidi A, Salehi M, Piroozmand A, Sagheb M . Effects of zinc supplementation on serum zinc and C-reactive protein concentrations in hemodialysis patients. J Ren Nutr. 2009; 19(6):475-8. DOI: 10.1053/j.jrn.2009.04.005. View

13.

Brodersen H, Holtkamp W, Larbig D, Beckers B, Thiery J, Lautenschlager J . Zinc supplementation and hepatitis B vaccination in chronic haemodialysis patients: a multicentre study. Nephrol Dial Transplant. 1995; 10(9):1780. View

14.

Lobo J, Stockler-Pinto M, Elias Farage N, Faulin T, Saes Parra Abdalla D, Torres J . Reduced plasma zinc levels, lipid peroxidation, and inflammation biomarkers levels in hemodialysis patients: implications to cardiovascular mortality. Ren Fail. 2013; 35(5):680-5. DOI: 10.3109/0886022X.2013.789960. View

15.

Jern N, Vanbeber A, Gorman M, Weber C, Liepa G, Cochran C . The effects of zinc supplementation on serum zinc concentration and protein catabolic rate in hemodialysis patients. J Ren Nutr. 2000; 10(3):148-53. DOI: 10.1053/jren.2000.7413. View

16.

Kobayashi H, Abe M, Okada K, Tei R, Maruyama N, Kikuchi F . Oral zinc supplementation reduces the erythropoietin responsiveness index in patients on hemodialysis. Nutrients. 2015; 7(5):3783-95. PMC: 4446779. DOI: 10.3390/nu7053783. View

17.

Matson A, Wright M, Oliver A, Woodrow G, King N, Dye L . Zinc supplementation at conventional doses does not improve the disturbance of taste perception in hemodialysis patients. J Ren Nutr. 2003; 13(3):224-8. DOI: 10.1016/s1051-2276(03)00072-4. View

18.

Stewart-Knox B, Simpson E, Parr H, Rae G, Polito A, Intorre F . Zinc status and taste acuity in older Europeans: the ZENITH study. Eur J Clin Nutr. 2005; 59 Suppl 2:S31-6. DOI: 10.1038/sj.ejcn.1602295. View

19.

Keast R, Canty T, Breslin P . Oral zinc sulfate solutions inhibit sweet taste perception. Chem Senses. 2004; 29(6):513-21. DOI: 10.1093/chemse/bjh053. View

20.

Pakfetrat M, Shahroodi J, Zolgadr A, Larie H, Nikoo M, Malekmakan L . Effects of zinc supplement on plasma homocysteine level in end-stage renal disease patients: a double-blind randomized clinical trial. Biol Trace Elem Res. 2013; 153(1-3):11-5. DOI: 10.1007/s12011-013-9639-2. View