Trace Element Abnormalities in Chronic Uremia

摘要

Trace element profiles have been fully characterized in dialyzed and non-dialyzed uremic patients. A number of trace element alterations have been found. Uremic patients have an increased total body burden of tin, strontium, aluminum and zinc and a decreased body burden of rubidium. In addition they have isolated tissue trace element disturbances of iron which is increased in liver and spleen and copper which is increased in lung but decreased in heart. A final disturbance in trace elements would appear to be a translocation of cadmium and molybdenum from the diseased kidney to the liver. It would appear that most trace element disturbances that occur in uremic patients are a consequence of uremia and loss of renal function rather than induced by dialysis. Furthermore dialysis was found to improve only one elemental alteration, liver cadmium excess. In dialyzed uremics neither water treatment for the preparation of the dialysate nor environmental or geographical factors appeared to have any effect on the body burden of trace elements, excepting aluminum. The toxicity of the retained aluminum in uremic patients has been reasonably well established. However, the clinical importance of the other elemental alterations found in uremic patients remains to be elucidated.