Concentrations of Trace Elements and Clinical Outcomes in Hemodialysis Patients A Prospective Cohort Study

摘要: Background and objectives Deficiency of essential trace elements excess potentially toxic are common in patients on hemodialysis. Whether these abnormalities associated with poor outcomes is unknown but worth investigating, because they treatable. Design, setting, participants, & measurements We did a prospective longitudinal study 1278 incident hemodialysis, assessing blood concentrations 25 at baseline. used adjusted logistic regression to evaluate the association between element status four (death, cardiovascular events, systemic infection, hospitalization). A priori hypotheses concerned ( 1 ) deficiency zinc, selenium, manganese 2 lead, arsenic, mercury. Concentrations other 19 were tested hypothesis-generating analyses. Results Over years follow-up, 260 (20%) died, 285 (24%) experienced event, 117 (10%) hospitalized for 928 (77%) any cause. Lower zinc or higher mercury not independently risk clinical outcomes. selenium strongly death (odds ratio, 0.86 per decile; 99.2% confidence interval, 0.80 0.93) all-cause hospitalization 0.92 0.98). In exploratory analyses, copper significantly 1.07 1.00 1.15), cadmium levels highest decile 1.89; 1.06 3.38). Conclusions outcomes, lower risks hospitalization.