The effect of oral zinc on hemoglobin and dose of erythropoietin in hemodialysis patients

J Res Med Sci. 2024 Feb 23:28:85. doi: 10.4103/jrms.jrms_271_23. eCollection 2023.

Abstract

Background: In hemodialysis (HD) patients, low serum zinc level could cause hyporesponsivity to erythropoiesis-stimulating agents and lead to anemia. This study investigated the effects of oral zinc supplements on the required dose of erythropoietin in patients undergoing HD.

Materials and methods: In a double-blinded randomized trial, 76 HD patients were assigned to 2 groups of 38. One group (intervention) was treated with oral zinc supplements of 210 mg, daily for 6 months, and the other group (control) used placebo capsules for 6 months. The serum zinc level, hemoglobin level, and required dose of erythropoietin, albumin, ferritin, ferrous, and total iron-binding capacity were evaluated 3 and 6 months after intervention.

Results: Repeated measures ANOVA did not show a significant increase in Hb level after 6 months of intervention (P = 0.28). However, the required dose of erythropoietin was decreased, but the changes were not statistically significant (P > 0.05). The changes in the other variables were not statistically significant.

Conclusion: Oral zinc supplementation in HD patients could not increase hemoglobin level irrespective of their serum zinc level.

Keywords: Anemia; erythropoietin; renal dialysis; zinc level.