Skip to main content
SpringerLink
Log in

The Divalent Elements Changes in Early Stages of Chronic Kidney Disease

  • Published:
Biological Trace Element Research Aims and scope Submit manuscript

Abstract

As the glomerular filtration rate (GFR) decreases, it can cause imbalance in some divalent elements. These imbalances can cause increased oxidative stress in patients with renal impairment. The aim of present study was to investigate the changes of these divalent elements with CKD progression. One hundred and ninety-four patients with chronic kidney diseases (CKD) were divided into five stages, stage 1, 2, 3a, 3b, 4, and were recruited into this study. The divalent elements, calcium, magnesium, phosphorus, as well as iron, zinc, and copper were determined in clinical chemistry analyzer. Higher CKD stages were found to be associated with increased levels of phosphorus and copper; Ptrend values were 0.002 and 0.004, respectively. Also, higher CKD stages were associated with decreased levels of zinc; Ptrend value was 0.002, after adjustment for age, gender, smoke, education, diabetes, hypertension, and BMI. Decreased levels of zinc and elevated levels of phosphorus and copper might increase the oxidative stress and complications in CKD patients. Future randomized studies are needed to show whether adjusting dietary intake of phosphorus, copper, and zinc might affect the progression of CKD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Schieppati A, Remuzzi G (2005) Chronic renal diseases as a public health problem: epidemiology, social, and economic implications. Kidney Int Suppl 98:S7–10

    Article  Google Scholar 

  2. Thomas R, Kanso A, Sedor JR (2008) Chronic kidney disease and its complications. Prim Care 35(2):329–344. https://doi.org/10.1016/j.pop.2008.01.008

    Article  PubMed  PubMed Central  Google Scholar 

  3. Balasubramanian S (2013) Progression of chronic kidney disease: mechanisms and intervention in retardation. J Ap Med 10:19–28

    Google Scholar 

  4. National Kidney Foundation (2002) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Kidney disease outcome quality initiative. Am J Kidney Dis 39:S1–266

    Google Scholar 

  5. Schriffin E, Lipman M, Mann J (2007) Chronic kidney disease effects on the cardiovascular system. Circulation 116(1):85–97. https://doi.org/10.1161/CIRCULATIONAHA.106.678342

    Article  Google Scholar 

  6. Cachofeiro V, Goicochea M, de Vinuesa SG, Oubiña P, Lahera V, Luño J (2008) Oxidative stress and inflammation, a link between chronic kidney disease and cardiovascular disease. Kidney Int Suppl 111:S4–S9

    Article  CAS  Google Scholar 

  7. Modaresi A, Nafar M, Sahraei Z (2015) Oxidative stress in chronic kidney disease. Iran J Kidney Dis 9(3):165–179

    PubMed  Google Scholar 

  8. Putri AY, Thaha M (2014) Role of oxidative stress on chronic kidney disease progression. Acta Med Indones 46(3):244–252

    PubMed  Google Scholar 

  9. Shah S, Baliga R, Rajapurkar M, Fonseca V (2007) Oxidants in chronic kidney disease. J Am Soc Nephrol 18(1):16–28. https://doi.org/10.1681/ASN.2006050500

    Article  CAS  PubMed  Google Scholar 

  10. Saliba W, El-Haddad B (2009) Secondary hyperparathyroidism: pathophysiology and treatment. J Am Board Fam Med 22(5):574–581. https://doi.org/10.3122/jabfm.2009.05.090026

    Article  PubMed  Google Scholar 

  11. Barbier O, Jacquillet G, Tauc M, Cougnon M, Poujeol P (2005) Effect of heavy metals on, and handling by, the kidney. Nephron Physiol 99:105–110

    Article  CAS  Google Scholar 

  12. Prasad AS (2014) Zinc is an antioxidant and anti-inflammatory agent—its role in human health. Front Nutr 1:14

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. de Baaij JH, Hoenderop JG, Bindels RJ (2015) Magnesium in man: implications for health and disease. Physiol Rev 95(1):1–46. https://doi.org/10.1152/physrev.00012.2014

    Article  CAS  PubMed  Google Scholar 

  14. Zheltova AA, Kharitonova MV, Iezhitsa IN, Spasov AA (2016) Magnesium deficiency and oxidative stress: an update. Biomedicine (Taipei) 6(4):20. https://doi.org/10.7603/s40681-016-0020-6

    Article  Google Scholar 

  15. Tapiero H, Townsend DM, Tew KD (2003) Trace elements in human physiology and pathology. Copper. Biomed Pharmacother 57(9):386–398. https://doi.org/10.1016/S0753-3322(03)00012-X

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Henle ES, Luo Y, Gassmann W, Linn S (1996) Oxidative damage to DNA constituents by iron-medicated Fenton reactions. J Biol Chem 271(35):21177–21186. https://doi.org/10.1074/jbc.271.35.21177

    Article  CAS  PubMed  Google Scholar 

  17. Ayala A, Muñoz MF, Argüelles S (2014) Lipid peroxidation: production, metabolism, and signaling mechanisms of malondialdehyde and 4-hydroxy-2-nonenal. Oxidative Med Cell Longev 2014:1–31. https://doi.org/10.1155/2014/360438

    Article  CAS  Google Scholar 

  18. Repetto MG, Ferrarotti NF, Boveris A (2010) The involvement of transition metal ions on iron-dependent lipid peroxidation. Arch Toxicol 84(4):255–262. https://doi.org/10.1007/s00204-009-0487-y

    Article  CAS  PubMed  Google Scholar 

  19. Dewitte K, Dhondt A, Giri M, Stöckl D, Rottiers R, Lameire N, Thienpont LM (2004) Differences in serum ionized and total magnesium values during chronic renal failure between nondiabetic and diabetic patients: a cross-sectional study. Diabetes Care 27(10):2503–2505. https://doi.org/10.2337/diacare.27.10.2503

    Article  CAS  PubMed  Google Scholar 

  20. Mafra D, Cuppari L, Cozzolino SM (2002) Iron and zinc status of patients with chronic renal failure who are not on dialysis. J Ren Nutr 2:38–41

    Article  Google Scholar 

  21. Esfahani ST, Hamidian MR, Madani A, Ataei N, Mohseni P, Roudbari M, Haddadi M (2006) Serum zinc and copper levels in children with chronic renal failure. Pediatr Nephrol 21(8):1153–1156. https://doi.org/10.1007/s00467-006-0119-1

    Article  PubMed  Google Scholar 

  22. Minutolo R, Locatelli F, Gallieni M, Bonofiglio R, Fuiano G, Oldrizzi L, Conte G, De Nicola L, Mangione F, Esposito P, Dal Canton A, REport of COmorbidities in non-Dialysis Renal Disease Population in Italy (RECORD-IT) Study Group (2013) Anaemia management in non-dialysis chronic kidney disease (CKD) patients: a multicentre prospective study in renal clinics. Nephrol Dial Transplant 28(12):3035–3045. https://doi.org/10.1093/ndt/gft338

    Article  CAS  PubMed  Google Scholar 

  23. Deori R, Bhuyan B (2016) Iron status in chronic kidney disease patients. Int J Res Med Sci 4:3229–3234

    Article  Google Scholar 

  24. Lee MJ, Jung CH, Kang YM, Jang JE, Leem J, Park JY, Lee WJ (2015) Serum ceruloplasmin level as a predictor for the progression of diabetic nephropathy in Korean men with type 2 diabetes mellitus. Diabetes Metab J 39(3):230–239. https://doi.org/10.4093/dmj.2015.39.3.230

    Article  PubMed  PubMed Central  Google Scholar 

  25. Ikizler TA (2009) CKD classification: time to move beyond KDOQI. J Am Soc Nephrol 20(5):929–930. https://doi.org/10.1681/ASN.2009030309

    Article  PubMed  Google Scholar 

  26. Rule AD (2010) The CKD-EPI equation for estimating GFR from serum creatinine: real improvement or more of the same? Clin J Am Soc Nephrol 5(6):951–953. https://doi.org/10.2215/CJN.03110410

    Article  PubMed  Google Scholar 

  27. Westgard JO, Seehafer JJ, Barry PL (1994) Allowable imprecision for laboratory tests based on clinical and analytical test outcome criteria. Clin Chem 40(10):1909–1914

    Article  CAS  PubMed  Google Scholar 

  28. Al-Timimi DJ, Sulieman DM, Hussen KR (2014) Zinc status in type 2 diabetic patients: relation to the progression of diabetic nephropathy. J Clin Diagn Res 8(11):CC04–CC08. https://doi.org/10.7860/JCDR/2014/10090.5082

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Rakhshanizadeh F, Mohammad E (2014) Serum zinc, copper, selenium, and lead levels in children with chronic renal failure. Rev Clin Med 1:21–24

    Google Scholar 

  30. Tapiero H, Tew KD (2003) Trace elements in human physiology and pathology: zinc and metallothioneins. Biomed Pharmacother 57(9):399–411. https://doi.org/10.1016/S0753-3322(03)00081-7

    Article  CAS  PubMed  Google Scholar 

  31. Jung CH, Lee WJ, JH Y, Hwang JY, Shin MS, Koh EH, Kim MS, Park JY (2011) Elevated serum ceruloplasmin levels are associated with albuminuria in Korean men with type 2 diabetes mellitus. Diabetes Res Clin Pract 94(1):e3–e7. https://doi.org/10.1016/j.diabres.2011.06.019

    Article  CAS  PubMed  Google Scholar 

  32. Small DM, Coombes JS, Bennett N, Johnson DW, Gobe GC (2012) Oxidative stress, anti-oxidant therapies and chronic kidney disease. Nephrology 17(4):311–321. https://doi.org/10.1111/j.1440-1797.2012.01572.x

    Article  CAS  PubMed  Google Scholar 

  33. He J, Tell GS, Tang YC, Mo PS, He GQ (1992) Relation of serum zinc and copper to lipids and lipoproteins: the Yi people study. J Am Coll Nutr 11(1):74–78. https://doi.org/10.1080/07315724.1992.10718199

    Article  CAS  PubMed  Google Scholar 

  34. Iskra M, Patelski J, Majewski W (1993) Concentrations of calcium, magnesium, zinc and copper in relation to free fatty acids and cholesterol in serum of atherosclerotic men. J Trace Elem Electrolytes Health Dis 7(3):185–188

    CAS  PubMed  Google Scholar 

  35. Lin CC, Huang HH, CW H, Chen BH, Chong IW, Chao YY, Huang YL (2014) Trace elements, oxidative stress and glycemic control in young people with type 1 diabetes mellitus. J Trace Elem Med Biol 28(1):18–22. https://doi.org/10.1016/j.jtemb.2013.11.001

    Article  CAS  PubMed  Google Scholar 

  36. Malavolta M, Giacconi R, Piacenza F, Santarelli L, Cipriano C, Costarelli L, Tesei S, Pierpaoli S, Basso A, Galeazzi R, Lattanzio F, Mocchegiani E (2010) Plasma copper/zinc ratio: an inflammatory/nutritional biomarker as predictor of all-cause mortality in elderly population. Biogerontology 11(3):309–319. https://doi.org/10.1007/s10522-009-9251-1

    Article  CAS  PubMed  Google Scholar 

  37. Viaene L, Meijers BK, Vanrenterghem Y, Evenepoel P (2012) Evidence in favor of a severely impaired net intestinal calcium absorption in patients with (early-stage) chronic kidney disease. Am J Nephrol 35(5):434–441. https://doi.org/10.1159/000338299

    Article  CAS  PubMed  Google Scholar 

  38. Hill KM, Martin BR, Wastney ME, McCabe GP, Moe SM, Weaver CM, Peacock M (2013) Oral calcium carbonate affects calcium but not phosphorus balance in stage 3–4 chronic kidney disease. Kidney Int 83(5):959–966. https://doi.org/10.1038/ki.2012.403

    Article  CAS  PubMed  Google Scholar 

  39. Hill Gallant KM, Spiegel DM (2017) Calcium balance in chronic kidney disease. Curr Osteoporos Rep 15(3):214–221. https://doi.org/10.1007/s11914-017-0368-x

    Article  PubMed  PubMed Central  Google Scholar 

  40. Zumbrennen-Bullough K, Babitt JL (2014) The iron cycle in chronic kidney disease (CKD): from genetics and experimental models to CKD patients. Nephrol Dial Transplant 29(2):263–273. https://doi.org/10.1093/ndt/gft443

    Article  CAS  PubMed  Google Scholar 

  41. Cunningham J, Rodríguez M, Messa P (2012) Magnesium in chronic kidney disease Stages 3 and 4 and in dialysis patients. Clin Kidney 5(Suppl 1):i39–i51. https://doi.org/10.1093/ndtplus/sfr166

    Article  CAS  Google Scholar 

  42. Dai Q, Motley SS, Smith JA Jr, Concepcion R, Barocas D, Byerly S, Fowke JH (2011) Blood magnesium, and the interaction with calcium, on the risk of high-grade prostate cancer. PLoS One 6(4):e18237. https://doi.org/10.1371/journal.pone.0018237

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

This study was supported by Fooyin University Hospital (Grant no: FH-HR-100-03).

Author information

Authors and Affiliations

  1. Department of Laboratory Medicine, Fooyin University Hospital, Pingtung, Taiwan

    Wan-Ju Kung

  2. Department of Family Medicine, Fooyin University Hospital, Pingtung, Taiwan

    Ching-Tang Shih

  3. Department of Public Health and Environmental Medicine Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan

    Chien-Hung Lee

  4. Department of Medical Laboratory Science and Biotechnology, Fooyin University, Kaohsiung, Taiwan

    Ching-Chiang Lin

  5. Department of Education and Research, Fooyin University Hospital, Pingtung, Taiwan

    Ching-Chiang Lin

Authors
  1. Wan-Ju Kung
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ching-Tang Shih
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chien-Hung Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ching-Chiang Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ching-Chiang Lin.

Ethics declarations

Conflicts of Interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kung, WJ., Shih, CT., Lee, CH. et al. The Divalent Elements Changes in Early Stages of Chronic Kidney Disease. Biol Trace Elem Res 185, 30–35 (2018). https://doi.org/10.1007/s12011-017-1228-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12011-017-1228-3

Keywords

Search

Navigation