Altered Mineral Metabolism and Disequilibrium Between Calcification Promoters and Inhibitors in Chronic Hemodialysis Patients

  • Chia-Liang Wang
  • Kuan-Pin Lin
  • Guoo-Shyng W. Hsu
  • Kai-Li LiuEmail author
  • Chih-Hung GuoEmail author


Patients undergoing long-term hemodialysis (HD) are known to have abnormal blood concentrations of antioxidant minerals; concurrent oxidative stress can contribute to increased vascular calcification. This study aims to evaluate the associations between circulating antioxidant minerals and clinical biomarkers of vascular calcification in HD patients. Blood biochemical parameters, antioxidant minerals (selenium (Se), zinc (Zn), copper (Cu), and magnesium (Mg)), and several promoters and inhibitors of calcification (matrix Gla protein (MGP), fibroblast growth factor-23 (FGF-23), matrix metalloproteinases (MMP-2 and -9), and tissue inhibitors of metalloproteinase (TIMP-1 and -2)) were determined in HD patients (n = 62) and age- and sex-matched healthy individuals (n = 30). Compared with healthy subjects, HD patients had significantly lower plasma concentrations of Se and Zn, increased Cu and Mg, and higher levels of oxidative stress and inflammatory markers (Cu/Zn ratios, malondialdehyde (MDA), advanced glycation end products (AGEs), and C-reactive protein (CRP)). We observed that HD patients had significantly lower concentrations of MGP and higher levels of FGF-23, MMP-2 and -9, TIMP-1 and -2, and MMP-2/TIMP-2 and MMP-9/TIMP-1 ratios. We also observed significant relationships between the concentrations of these minerals and calcification biomarkers in HD patients. These results suggest that changes in the homeostasis of antioxidant minerals (Se, Zn, Cu, and Mg) may contribute to the effects of oxidative stress and inflammatory status, thereby participating in the mechanism for accelerated vascular calcification in patients undergoing long-term HD.


Vascular calcification antioxidant minerals oxidative stress inflammation hemodialysis patients 


Author Contributions

C-L Wang, K-L Liu, and C-H Guo conceived and designed the experiments. C-L Wang, K-L Liu, and C-H Guo performed the experiments. G-S-W Hsu, KP Lin, and C-H Guo analyzed the data. C-L Wang and C-H Guo wrote the paper.

Funding Information

Research supported in part by the grant from the Kuang-Tien General Hospital and the Hung-Kuang University, Taichung, Taiwan.

Compliance with Ethical Standards

The research protocol was approved by the ethics in human research committee of the Kuang-Tien General Hospital.

Competing Interests

The authors declare that they have no competing interests.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of NephrologyKuang-Tien General HospitalTaichungTaiwan, Republic of China
  2. 2.Institute of Biomedical NutritionHung-Kuang UniversityTaichungTaiwan, Republic of China
  3. 3.Department of NutritionChung-Shan Medical UniversityTaichungTaiwan, Republic of China
  4. 4.Department of NursingHung-Kuang UniversityTaichungTaiwan, Republic of China
  5. 5.Department of Nutritional ScienceFu Jen UniversityNew Taipei CityTaiwan, Republic of China
  6. 6.Department of NutritionChung Shan Medical University HospitalTaichungTaiwan, Republic of China
  7. 7.Department of Medical ResearchChina Medical University HospitalTaichungTaiwan, Republic of China
  8. 8.Taiwan Nutraceutical AssociationTaipeiTaiwan, Republic of China

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