Mater Hospital, Sydney, New South Wales
Aim: To describe the prevalence of serum zinc deficiency and to identify associated factors in a cohort of maintenance haemodialysis (HD) patients.
Background: Zinc deficiency is associated with a number of issues including reduced taste perception and appetite, fatigue and increased susceptibility to infection. Zinc deficiency is known to occur in HD patients, however, little is known about the characteristics of patients most at risk.
Methods: Routine blood work with the addition of serum zinc was collected on 34 maintenance HD patients at the Mater Dialysis Unit, North Sydney between June and August 2016. Two patients attending the unit were not included as they were away during this time. Nutrition assessment using the Subjective Global Assessment (SGA) on all 34 patients was conducted by the renal Dietitian during the same time period.
Results: Forty one percent (14/34 patients; 9/22 men and 5/12 women) were found to have low serum zinc levels indicating deficiency. Malnutrition was significantly associated with zinc deficiency (p = 0.003), with all malnourished patients but one also having low serum zinc. Increased inflammation as indicated by high CRP was also significantly associated with zinc deficiency (p = 0.0024). There was also a trend towards higher rates of zinc deficiency among patients with lower BMI (p= 0.07) and those requiring nutrition supplements (p = 0.08), although these did not reach statistical significance. Age, gender, serum albumin and dialysis vintage were not associated with zinc deficiency.
Conclusions: HD patients at increased risk of zinc deficiency include those who are malnourished, have persistently high CRP/inflammation, with lower BMI, or requiring nutrition supplements. Consideration should be given to the possibility of zinc deficiency in these patients.