Evaluation of trace element levels in chronic kidney patients in childhood

Aim and Background: Trace elements are substances found in very low concentrations in biological fluids or tissues, which can sometimes cause deficiency and toxicity in chronic kidney disease patients. In the routine follow-up of chronic kidney patients, serum levels of trace elements are not evaluated. In our study, we aimed to evaluate trace element levels and the relationship of trace elements with anthropometric and biochemical parameters in chronic kidney disease patients. Method: Children who were diagnosed as chronic kidney disease (CKD) (n: 64) with GFR below 60 ml/ min/1.73 m2 in Gaziantep University Hospital Department of Pediatric Nephrology and healthy voluntary children (n: 25) were included in the study. Patients with CKD were divided into stage 3-4 CKD (n: 27), haemodialysis (HD) (n: 12) and peritoneal dialysis (PD) (n: 25) groups. In all patients and in the control group, zinc (Zn) and copper (Cu) were measured in serum with a fully automatic biochemistry autoanalizer. Serum selenium (Se), manganese (Mn), lead (Pb), cadmium (Cd), chromium (Cr) and nickel (Ni) were measured by inductively coupled plasma optical emission spectrometry (ICP-OES) method. Simultaneous anthropometric measurements, biochemical and haematological examinations of patient and volunteer groups were performed. Results: Serum copper median value; in the control group, 178 µg / dl (135.2 -270.3); In stage 3-4 CKD patients, 129.4 µg / dl (108.6 -139.1); In HD patients, 106.35 µg / dl (96.25 - 130.5); In PD patients, 135.4 µg / dl (122.5 -144.4) was detected. Copper level was found higher in the control group compared to the patient groups, and this difference was significant (p=0.001). There was no significant difference between the groups in serum zinc Zn, Cr, Ni, Se and Pb levels (p>0.05). When the relationship between anthropometric values and trace element levels is examined; There was a significant relationship between Zn and height SDS, Cr and BMI SDS in stage 3-4 CKD group, between Cu and height SDS, Ni and BMI SDS and weight SDS in HD group, and between Zn and BMI SDS and weight SDS in the control group (p<0.05). When the relationship between trace element levels and laboratory values is examined; There was a significant relationship; between Se and hemoglobin and between Cr and iron in stage 3-4 CKD group; between Cu and phosphorus (P), calcium x phosphorus (CaxP) and total cholesterol in HD group; between Ni and P, Ca x P and between Cu, Pb, Ni and parathormone in PD group; and also between Ni and glomerular filtration rate and Se and albumin in the control group (p<0.05). Conclusion: In the evaluation of Zn, Cu, Se, Cr, Ni and Pb in children with chronic renal disease, it was determined that only the level of Cu is low. Although Cr level, which is one of the toxic trace elements, is higher in haemodialysis patients compared to other groups, a statistically significant level could not be determined. Keywords: Chronic Kidney Disease, Serum Trace Element Levels