Variation of trace element concentrations in patients undergoing hemodialysis in the north of Spain

Scand J Clin Lab Invest. 2016 Oct;76(6):492-9. doi: 10.1080/00365513.2016.1201852. Epub 2016 Jun 30.


Background: Trace elements are essential substances for the proper physiological and biochemical functioning of the organism. Hemodialysis patients are potentially at risk of deficiency or excess of these elements. The application of inductively coupled plasma mass spectrometry (ICP-MS) allows the simultaneous quantification of very small amounts of multiple trace elements. The aim was to measure the serum concentration of copper (Cu), zinc (Zn), selenium (Se), and nickel (Ni), and the whole blood concentration of arsenic (As), lead (Pb), and manganese (Mn), in patients undergoing hemodialysis as well as in controls.

Methods: The study was carried out in 57 hemodialysis patients compared with 57 controls with normal renal function. Serum and whole blood samples from the dialysis group were collected before and after hemodialysis sessions and Cu, Zn, Se, Ni, As, Pb and Mn levels were determined using ICP-MS.

Results: Hemodialysis patients showed significantly lower blood levels of Cu, Zn and Se than controls (p < 0.001) and higher concentrations of Ni, As and Pb (p < 0.0001). The levels of Mn were similar in both groups. After performing hemodialysis, Cu, Zn, Se and Ni concentrations were significantly higher than the pre-hemodialysis levels (p < 0.0001). However, the concentration of As decreased (p < 0.0001) and Pb and Mn levels were not significantly altered after the dialysis session.

Conclusion: Hemodialysis patients are at increased risk of trace elements deficiency (especially for Zn and Se) or excess (Ni) in respect to healthy subjects. Monitoring of blood levels and supplementation of some trace elements may be indicated in patients undergoing hemodialysis.

Keywords: Hemodialysis; mass spectrometry; toxic metals; trace elements.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arsenic / blood
  • Biomarkers / blood
  • Case-Control Studies
  • Copper / blood
  • Female
  • Humans
  • Kidney Diseases / blood*
  • Kidney Diseases / therapy
  • Lead / blood
  • Male
  • Manganese / blood
  • Middle Aged
  • Nickel / blood
  • Renal Dialysis
  • Selenium / blood
  • Spain
  • Trace Elements / blood
  • Young Adult
  • Zinc / blood


  • Biomarkers
  • Trace Elements
  • Lead
  • Manganese
  • Copper
  • Nickel
  • Selenium
  • Zinc
  • Arsenic