Clinical Factors Associated With Serum Copper Concentration In Patients On Hemodialysis

Abstract

It is well known that renal insufficiency influences trace element metabolism. In particular, patients treated with hemodialysis (HD) are at higher risk for both deficiency and excess of trace elements. However, derangements of serum trace element levels reported by previous studies were sometimes inconsistent. In addition, harmful effects by trace element derangements seem quite unclear. In this cross-sectional study, we examined clinical factors associated with serum copper levels in patients treated with HD for more than or equal to 6 months. In 49 patients (male : female =29 : 20, age 71 ± 10 years, HD duration 84 ± 71 months), the mean value of serum copper was 93.8 ± 16.2 μg/dL. In univariate analysis, there were no significant correlation between serum copper levels and patient’s age, sex, HD duration, the presence of diabetes mellitus, serum albumin levels, and body mass index. Serum copper levels significantly correlated with serum levels of high-sensitivity C-reactive protein (hs-CRP; r=0.474, P=0.001) and malondialdehyde-low-density lipoprotein (r=0.371, P=0.009). It was notable that serum copper levels tended to be lower in those treated with higher dose of sevelamer hydrochloride (r=−0.255, P=0.07). In multivariate analysis, hs-CRP remained to be an independent determinant of serum copper levels. We showed significant association of serum copper levels with inflammation and oxidative stress in HD patients. Further studies are required to investigate whether sevelamer may improve serum copper levels, inflammation, and oxidative stress.