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Evaluation of Serum Zinc Level among Hemodialysis Sudanese Patients with Erythropoietin Resistant

Background: Anemia is principle health problem in patients with chronic renal failure on hemodialysis treatment and erythropoietin is treatment of choice, some patients do not respond as expected. Various researches suggest that zinc may play a role in the etiology of erythropoietin resistant anemia. Objectives: To assess serum zinc level in erythropoietin resistant hemodialysis Sudanese patients and its relation to hemoglobin and comparison with apparently non erythropoietin resistant hemodialysis control patients. Materials and methods: Case control study was performed in Khartoum state at kidney disease clinic Khartoum Sudan, during the period from February to October 2018. 50 samples were collected from erythropoietin resistant Hemodialysis patients test group. In addition to other 50 from non-erythropoietin resistant hemodialysis patient’s sex and age matched control group. The levels of serum zinc elements were determined in both groups by atomic absorption spectroscopy, and hemoglobin was measured by colorimetric method. Results: Serum zinc level was significantly lower in erythropoietin resistant hemodialysis patients when compared with non-erythropoietin resistant hemodialysis patients control group (0.26 ± 0.08 mg/L versus 0.67 ± 0.09 mg/L). Furthermore Hb was significantly decreased (8.56 ± 0.56 gm/L versus 11.34 ± 0.59 gm/dl, p=0.000). In addition the study observed no significant difference in zinc level and hemoglobin across gender (P>0.05) in the test group. Also the study recorded serum zinc level is significantly correlated with Hb (R=0.58, P=0.00) and inversely correlated with age (R=-43, P=0.01). Whereas Hb level is insignificantly correlated with patients age in the study group (R=0.24, p=0.16). Conclusion: Erythropoietin resistant anemia in hemodialysis patients is associated with reduced serum zinc level. Which provide evidence that serum zinc levels should be measure especially in hemodialysis patients resistant to erythropoietin therapy.


Amal Elbadri, Ibrahim Kheiri and Abdelmula Mohamed Abdalla

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