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Published in: BMC Nephrology 1/2015

Open Access 01-12-2015 | Research article

Trace element supplementation in hemodialysis patients: a randomized controlled trial

Authors: Marcello Tonelli, Natasha Wiebe, Stephanie Thompson, David Kinniburgh, Scott W Klarenbach, Michael Walsh, Aminu K Bello, Labib Faruque, Catherine Field, Braden J Manns, Brenda R Hemmelgarn, for the Alberta Kidney Disease Network

Published in: BMC Nephrology | Issue 1/2015

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Abstract

Background

People with kidney failure are often deficient in zinc and selenium, but little is known about the optimal way to correct such deficiency.

Methods

We did a double-blind randomized trial evaluating the effects of zinc (Zn), selenium (Se) and vitamin E added to the standard oral renal vitamin supplement (B and C vitamins) among hemodialysis patients in Alberta, Canada. We evaluated the effect of two daily doses of the new supplement (medium dose: 50 mg Zn, 75 mcg Se, 250 IU vitamin E; low dose: 25 mg Zn, 50 mcg Se, 250 IU vitamin E) compared to the standard supplement on blood concentrations of Se and Zn at 90 days (primary outcome) and 180 days (secondary outcome) as well as safety outcomes.

Results

We enrolled 150 participants. The proportion of participants with low zinc status (blood level <815 ug/L) did not differ between the control group and the two intervention groups at 90 days (control 23.9% vs combined intervention groups 23.9%, P > 0.99) or 180 days (18.6% vs 28.2%, P = 0.24). The proportion with low selenium status (blood level <121 ug/L) was similar for controls and the combined intervention groups at 90 days (32.6 vs 19.6%, P = 0.09) and 180 days (34.9% vs 23.5%, P = 0.17). There were no significant differences in the risk of adverse events between the groups.

Conclusions

Supplementation with low or medium doses of zinc and selenium did not correct low zinc or selenium status in hemodialysis patients. Future studies should consider higher doses of zinc (≥75 mg/d) and selenium (≥100 mcg/d) with the standard supplement.

Trial registration

Registered with ClinicalTrials.gov (NCT01473914)
Appendix
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Metadata
Title
Trace element supplementation in hemodialysis patients: a randomized controlled trial
Authors
Marcello Tonelli
Natasha Wiebe
Stephanie Thompson
David Kinniburgh
Scott W Klarenbach
Michael Walsh
Aminu K Bello
Labib Faruque
Catherine Field
Braden J Manns
Brenda R Hemmelgarn
for the Alberta Kidney Disease Network
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2015
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-015-0042-4

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