Trace elements in hemodialysis patients: a systematic review and meta-analysis

被引:211
作者
Tonelli, Marcello [1 ]
Wiebe, Natasha [1 ]
Hemmelgarn, Brenda [2 ]
Klarenbach, Scott [1 ]
Field, Catherine [3 ]
Manns, Braden [2 ]
Thadhani, Ravi [4 ]
Gill, John [5 ]
机构
[1] Univ Alberta, Dept Med, Edmonton, AB, Canada
[2] Univ Calgary, Dept Med, Calgary, AB T2N 1N4, Canada
[3] Univ Alberta, Dept Agr Food & Nutr Sci, Edmonton, AB, Canada
[4] Harvard Univ, Sch Med, Dept Med, Boston, MA USA
[5] Univ British Columbia, Dept Med, Vancouver, BC, Canada
来源
BMC MEDICINE | 2009年 / 7卷
基金
加拿大健康研究院;
关键词
CHRONIC-RENAL-FAILURE; GLUTATHIONE-PEROXIDASE ACTIVITIES; SERUM SELENIUM CONCENTRATION; ZINC TOLERANCE-TEST; BLOOD LEAD LEVELS; OXIDATIVE STRESS; UREMIC PATIENTS; CARDIOVASCULAR-DISEASE; LIPID-PEROXIDATION; PLASMA-LEVELS;
D O I
10.1186/1741-7015-7-25
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Hemodialysis patients are at risk for deficiency of essential trace elements and excess of toxic trace elements, both of which can affect health. We conducted a systematic review to summarize existing literature on trace element status in hemodialysis patients. Methods: All studies which reported relevant data for chronic hemodialysis patients and a healthy control population were eligible, regardless of language or publication status. We included studies which measured at least one of the following elements in whole blood, serum, or plasma: antimony, arsenic, boron, cadmium, chromium, cobalt, copper, fluorine, iodine, lead, manganese, mercury, molybdenum, nickel, selenium, tellurium, thallium, vanadium, and zinc. We calculated differences between hemodialysis patients and controls using the differences in mean trace element level, divided by the pooled standard deviation. Results: We identified 128 eligible studies. Available data suggested that levels of cadmium, chromium, copper, lead, and vanadium were higher and that levels of selenium, zinc and manganese were lower in hemodialysis patients, compared with controls. Pooled standard mean differences exceeded 0.8 standard deviation units (a large difference) higher than controls for cadmium, chromium, vanadium, and lower than controls for selenium, zinc, and manganese. No studies reported data on antimony, iodine, tellurium, and thallium concentrations. Conclusion: Average blood levels of biologically important trace elements were substantially different in hemodialysis patients, compared with healthy controls. Since both deficiency and excess of trace elements are potentially harmful yet amenable to therapy, the hypothesis that trace element status influences the risk of adverse clinical outcomes is worthy of investigation.
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页数:12
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