Effect of zinc supplementation on bone formation in hemodialysis patients with normal or low turnover bone

Figures & data

Figure 1. Flowchart for the process of patient selection.

Figure 2. Histogram of serum Zn in 67 male HD patients. Highlighted area shows a normal range (65–110 μg/dL) obtained in healthy individuals.

Table 1. Comparison of demographic and laboratory characteristics in patients with serum Zn < 65 μg/dL between participants for zinc supplementation study and the other patients.

Participants (n = 9)	Others (n = 42)	p^a	p^b
Zn (μg/dL)	58 (52–65)	57 (47–65)	0.2102
Age (years)	66 (35–78)	67 (35–91)	0.7385
HD vintage (months)	57 (4–97)	69 (4–336)	0.1448
DM: yes/no	5/4	17/25	0.4740
Dry weight (Kg)	60.0 (49.3–74.5)	61.9 (42.0–110.0)	0.8918
VD pulse: yes/no	5/4	16/26	0.4601
Alb (g/dL)	3.6 (3.2–4.4)	3.6 (3.2–5.1)	0.5086
CRP (mg/dL)	0.03 (0.01–0.17)	0.09 (0.01–1.85)	0.0474
ALP (IU/L)	142 (129–387)	225 (111–435)	0.0813
iP (mg/dL)	5.8 (3.8–6.6)	5.2 (2.9–6.7)	0.3042
cCa mg/dL)	9.2 (7.5–10.1)	9.2 (6.8–10.5)	0.7282
Intact PTH (pg/mL)	113 (6–310)	158 (6–804)	0.2256
BAP (μg/L)	8.5 (6.7–18.5)	11.0 (5.1–18.5)	0.4659
TRACP5b (mU/dL)	200 (98–684)	272 (98–1100)	0.5597

Notes: All values are expressed as median (range).

In others, n = 30 except for intact PTH (n = 33), BAP (n = 31) and TRACP5b (n = 31).

^aMann–Whitney test.

^bFisher’s exact probability test.

Figure 3. Changes of serum BAP up to 18 months during zinc supplementation. p = 0.0409: Jonckheere–Terpstra test, n = 9.

Table 2. Effects of zinc supplementation on serum Zn, bone metabolic markers and Alb from baseline up to 18 months.

	Baseline	3 months	6 months	12 months	18 months	p
Zn (μg/dL)	58 (52–65)	71 (57–93)*	72 (58–82)	73 (68–87)*	73 (62–120)*	0.0013
BAP (μg/L)	8.5 (6.7–18.5)	9.4 (5.0–18.9)	9.9 (7.2–17.1)	10.0 (7.9–21.1)	10.1 (7.6–25.4)	0.0118
TRACP5b (mU/dL)	200 (98–684)	225 (115–595)	203 (84–321)	368 (161–807)**	208 (88–536)	0.0020
Intact PTH (pg/mL)	113 (6–310)	128 (15–288)	129 (6–167)	126 (17–298)	82 (8–265)	0.2042
iP (mg/dL)	5.1 (3.4–7.1)	5.3 (4.2–6.0)	4.9 (3.3–5.6)	5.8 (3.8–7.2)	5.5 (4.2–7.1)**	0.0165
cCa (mg/dL)	9.8 (7.5–10.3)	9.1 (7.4–9.9)	9.2 (8.3–10.6)	9.1 (7.8–10.2)	9.2 (8.5–10.1)	0.2610
Alb (g/dL)	3.6 (3.2–4.4)	3.7 (3.2–4.3)	3.6 (3.3–4.1)	3.8 (3.3–4.4)	3.6 (3.3–4.1)	0.2407

Notes: All values are expressed as median (range); n = 9.

p: Friedman test.

Comparisons between groups were performed by Scheffe post hoc test:

*p < 0.05 versus baseline.

**p < 0.05 versus 6 months.