Abstract
Whole blood levels of Cd and Pb (μg/g Hb), serum concentrations of Sr and Zn and their urinary excretion were measured in healthy, renal transplant and dialyzed children by atomic absorption spectroscopy. Furthermore, before and after dialysis the concentrations of these elements were determined in blood/serum as well as in the dialysis fluid. The predialytic concentrations of Cd, Pb and Sr in blood/serum were significantly increased compared to controls. Haemodialysis had only minor effects on whole blood Cd and Pb levels but serum Sr and Zn concentrations increased as a result of high metal levels in dialysis fluid.
Children after renal transplantation showed no alterations in Pb, Sr and Zn concentrations compared to healthy children but whole blood Cd was increased.
According to the renal function the Pb, Cd and Zn urinary excretion decreased in the following order: healthy, renal transplant and dialysis children. Sr urinary excretion was increased in haemodialysis and renal transplant patients.
In conclusion, we found no Zn deficiency. Elevated blood levels of Cd and Pb and elevated Sr serum concentrations in paediatric patients undergoing dialysis and increased Cd whole blood levels in renal transplant children could be of clinical interest.
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References
Alfrey AC (1984) Aluminium toxicity. Bull NY Acad Med 60/2: 210–212
Alfrey AC, Rudolph H, Smythe WR (1975) Mineral metabolism in uremia. Kidney Int 7/2:85–89
Bodgen JD, Oleske JM, Winer B, Smith LG jr, Smith LG, Najem GR (1980) Elevated plasma zinc concentrations in renal dialysis patients. Am J Clin Nutr 33:1088–1095
Casey CE, Moser MC, Hambidge KM, Lum GM (1981) Zinc copper and vitamin A in pediatric dialysis. J Pediatr 5:434–435
Diekmann L, Ladas A, Schön B, Jenett WD, Michelis K, Fenders D (1976) Kupter, Eisen, Zink bei chronisch dialysierten Kindern. Nieren-und Hochdruckkrankheiten 6:239–242
Eggert JV, Maxwell JG, Eggert LD (1983) Healthy well-nourished renal transplant patients do not need zinc supplementation. Dial Transplant 12/10:714–718
Eikmann T, Einbrodt HJ (1983) Blei-, Zink-und Blutbildwerte von Erwachsenen und Kindern in ländlichen und städtischen Gebieten Ostwestfalens. Umwelthygiene Suppl 1:147–161
Ellis L (1978) Serum zinc levels and urinary zinc excretion in patients with renal transplantation. Clin Chim Acta 82:105–111
Etzel KR, Shapiro SG, Cousins RJ (1979) Regulation of liver metallothionein and plasma zinc by the glucocorticoid dexamethasone. Biochem Biophys Res Commun 89/4:1120–1126
Friberg L, Kjellström T, Nordberg GT, Piscator M (1979) In: Friberg L, Nordberg GF, Vouk VB (eds.) Handbook on the toxicology of metals. Elsevier North-Holland Biomedical Press, Amsterdam New York Oxford, pp 355–381
Gidden H, Holland FF, Klein E (1980) Trace metal protein binding in normal and dialyzed uremic serum. Am Soc Artif Intern Organs 26:133–138
Hutchings LL, Scholler DM, Valentine JS (1984) Influence of adrenalectomy and dexamethasone on rat liver metallothionein and superoxide dismutase activity. Inorg Chim Acta 91:L21-L22
Iyengar GV, Kollmer WE, Bowen HJM (1978) The elemental composition of human tissues and body fluids. Verlag Chemie, Weinheim New York
Jessen H, Kruse H, Piechotowski I (1984) Cadmiumkonzentrationen im Blut von Stadt- und Inselbewohnern in Schleswig-Holstein. Int Arch Occup Environ Health 54:45–54
Karin M, Herschmann HR (1979) Dexamethasone stimulation of metallothionein synthesis in HeLa cell cultures. Science 204:176–177
Kasperek K, Feinendegen LE, Lombeck I, Bremer HJ (1977) Serum zinc concentrations during childhood. Eur J Pediatr 126: 199–202
Lehnert G, Szadkowski D (1983) Die Bleibelastung des Menschen. Verlag Chemie, Weinheim New York
Mahajan SK, Prasad AS, Lambujon J, Abbasi AA, Briggs WA, Mc Donald FD (1980) Improvement of uremic hypogeusia by zinc: a double blind study. Am J Clin Nutr 33:1517–1521
Mahler DJ, Walsh JR, Hayne GD (1971) Magnesium, zinc and copper in dialysis patients. Am J Clin Pathol 56:17–23
Mansouri K, Halsted JA, Gombos EA (1970) Zinc, copper, magnesium and calcium in dialyzed and nondialyzed uremic patients. Arch Intern Med 125:88–93
Omdahl JL, De Luca HF (1971) Strontium induced rickets. Metabolic basis. Science 174:949–951
Parker MM, Humoller FL, Mahler DJ (1967) Determination of copper and zinc in biological material. Clin Chem 13:40–48
Petrie JJ, Row PG (1977) Dialysis anaemica caused by subacute zinc toxicity in hemodialysis. Lancet 1:1178–1180
Ritz E, Klooker P (1983) Zinkmangel bei Urämie? Akt Ernähr 8:128–132
Rose GA, Willden EG (1972) Whole blood, red cell and plasma total ultrafiltrable zinc levels in normal subjects and patients with chronic renal failure with and without hemodialysis. Br J Urol 44: 281–286
Ryan-Crowe CV, Crews MG, Stanbaugh G, Gillit D (1982) Taste response by zinc supplement in hemodialysis patients. Dial Transplant 11/4:1948–1951
Salvadeo A, Minola C, Segagni S, Villa G (1979) Trace metal changes in dialysis fluid and blood of patients on hemodialysis. Int J Artif Organs 2/1:17–21
Sandstead HH (1980) Trace elements in uremia and hemodialysis. Am J Clin Nutr 33:1501–1508
Schaller KH, Schneider L, Hall G, Valentin H (1984) Cadmiumgehalt im Vollblut bei Bewohnern verschiedener Regionen des Freistaates Bayern. Zbl Bakt Hyg I. Abt Orig B 178:446–463
Seelig HP (1969) Die Jaffé-Reaktion mit Kreatinin Reaktionsprodukt und allgemeine Reaktionsbedingungen. Z klin Chem u klin Biochem 7:581–585
Smythe WR, Alfrey AC, Craswell PW, Crouch CA, Ibels LS, Kubo H, Nunnelly LL, Rudolph H (1982) Trace element abnormalities in chronic uremia. Ann Intern Med 96:302–310
Sprenger KBG, Bundschuh D, Schmitz J, Franz HE (1983) Therapie des Zinkmangels bei Dialysepatienten. Nieren- und Hochdrukkrankheiten 12/6:234–238
Subramanian KS, Meranger JC (1981) A rapid electrothermal atomic absorption spectrometric method for cadmium and lead in human whole blood. Clin Chem 27/11:1866–1871
Subramanian KS, Meranger JC, MacKeen JE (1983) Graphite furnace atomic absorption spectrometry with matrix modification for the determination of cadmium and lead in human urine. Anal Chem 55:1064–1067
Thomson NM, Stevens BJ, Humphrey TJ, Atkins RC (1983) Comparison of trace elements in peritoneal dialysis, hemodialysis and uremia. Kidney Int 33:9–14
Tsukamato Y, Iwanami S, Marumo F (1980) Disturbances of trace element concentrations in plasma of patients with chronic renal failure. Nephron 26:174–179
Winneke G, Krämer U, Brockhaus A, Ewers U, Kujanek G, Lechner H, Janke W (1983) Neuropsychological studies in children with elevated tooth-lead concentrations. Int Arch Occup Environ Health 61:231–252
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Wilhelm, M., Hanewinckel, B. & Bläker, F. Influence of haemodialysis and renal transplantation on trace element concentrations in children with chronic renal failure. Eur J Pediatr 145, 372–376 (1986). https://doi.org/10.1007/BF00439241
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DOI: https://doi.org/10.1007/BF00439241