Comparison of trace elements in peritoneal dialysis, hemodialysis, and uremia

Abstract

Comparison of trace elements in peritoneal dialysis, hemodialysis, and uremia. The accumulation of trace elements, particularly aluminum, in patients on recurrent hemodialysis has been well described. However few studies of patients on recurrent peritoneal dialysis have been undertaken. In this study we examined the concentrations of zinc, copper, aluminum, manganese, lead, cadmium, and chromium in the blood of 31 patients on continuous ambulatory peritoneal dialysis (CAPD) and 10 patients on intermittent peritoneal dialysis (IPD) comparing the results with concentrations in 162 normal people, 71 patients with chronic renal failure but not on dialysis, and 44 patients on recurrent hemodialysis. Elements were measured by atomic absorption spectrophotometry. Patients on CAPD showed markedly reduced concentrations of red cell zinc and copper although a slight reduction was also present in hemodialysis patients. Moreover, aluminum retention in CAPD patients not taking aluminum hydroxide [Al(OH)3] therapy was significantly less than in those patients requiring Al(OH)3. Manganese, lead, and cadmium concentrations were normal in patients on CAPD although mild alterations were seen in the other patient groups. Chromium concentrations were increased to twice normal in CAPD and hemodialysis patients. The clinical significance of red cell copper and zinc depletion in CAPD has not yet been determined. The depletion mechanism of these two elements and of the accumulation of aluminum in CAPD patients is currently being investigated.