• ORAHIM D. YOUNAN Pharmacist, Directorate General of Health, Kurdistan region, Iraq.
  • SHERZAD K. RASHID Lecturer, Department of Pharmacology, college of pharmacy, university of Duhok, Duhok, Kurdistan region, Iraq.
  • AMER A. MEHE Lecturer, Department of clinical pharmacy, college of pharmacy, university of Duhok, Duhok, Kurdistan region, Iraq.
Keywords: zinc, anemia, chronic kidney disease, hemodialysis



Background: Zinc deficiency was reported in patients with chronic kidney disease especially among patients on hemodialysis. The objective was to assess the effect of zinc supplementations on the correction of anemia in those patients.

Patients and Methods: In this study, a total of 105 patients over 18-year old, stable and over 6 months on maintenance hemodialysis were enrolled. Blood samples were collected for biochemical and hematological assessments. The patients with zinc deficiency and anemia of chronic disorder were divided randomly into two groups and completed the study. Group 1 completed their treatment with the addition of zinc to their treatment as food supplementation (elementary zinc 50 mg/day) for 6 weeks and the other without zinc supplementation as a control group. Data collection carried out during the period from 8th January to 1st June 2019 at the kidney diseases center in Duhok city–Kurdistan region/Iraq. Serum zinc level and anemia parameters were determined.

Results: The patients in group 1 that received zinc supplementation showed a significant increase in the mean of serum zinc (mean of percentage 43.12 %) and correspondingly the mean of hemoglobin (mean of percentage 13.06 %).

Conclusion: There was a positive relationship between increase zinc level and the correction of anemia.


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1. GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016; 388(10053): 1459-544. doi: 10.1016/S0140-6736(16)31012-1.
2. Panjeta M, Tahirović I, Sofić E, Ćorić J, Dervišević A. Interpretation of erythropoietin and haemoglobin levels in patients with various stages of chronic kidney disease. J Med Biochem. 2017; 36(2): 145-52.
3. Hamed SA. Neurologic conditions and disorders of uremic syndrome of chronic kidney disease: presentations, causes, and treatment strategies. Expert Rev Clin Pharmacol. 2019; 12(1): 61-90. doi: 10.1080/ 17512433. 2019.1555468.
4. Vos FE, Schollum JB, Coulter C V, Doyle TCA, Duffull SB, Walker RJ. Red Blood Cell Survival in Long-term Dialysis Patients. Am J Kidney Dis. 2011; 58(4): 591-98. doi: 10.1053/ j.ajkd. 2011.03.031.
5. Babitt JL, Lin HY. Mechanisms of anemia in CKD. J Am Soc Nephrol. 2012; 23(10): 1631-34. doi: 10.1681/ ASN.2011111078.
6. Skalnaya MG, Skalny A V. Essential trace elements in human health: a physician’s view. 2018. Tomsk state university, Russia. Pp: 47
7. Imanishi M, Hori Y, Nagaoka M, Sugiura Y. Design of novel zinc finger proteins: towards artificial control of specific gene expression. Eur J Pharm Sci. 2001; 13(1): 91-7.
8. Roozbeh J, Hedayati P, Sagheb MM, Sharifian M, Hamidian Jahromi A, Shaabani S, et al . Effect of Zinc Supplementation on Triglyceride, Cholesterol, LDL, and HDL Levels in Zinc-Deficient Hemodialysis Patients. Ren Fail.2009; 31(9): 798-801. doi:10.3109/08860220903216055.
9. AL-Timimi D, Sulieman D, Hussen KR. Zinc Status in Type 2 Diabetic Patients: Relation to the Progression of Diabetic Nephropathy. J Clin Diagn Res. 2014; 8: CC04-8. doi: 10.7860/ JCDR/2014/10090.5082.
10. Jern NA, VanBeber AD, Gorman MA, Weber CG, Liepa GU, Cochran CC. The effects of zinc supplementation on serum zinc concentration and protein catabolic rate in hemodialysis patients. J Ren Nutr. 2000; 10(3): 148-53. doi:10.1053/jren.2000.7413.
11. Rahimi-Ardabili B, Argani H, Ghorbanihaghjo A, Rashtchizadeh N, Naghavi-Behzad M, Ghorashi S, et al . Paraoxonase Enzyme Activity Is Enhanced by Zinc Supplementation in Hemodialysis Patients. Ren Fail. 2012; 34(9): 1123-8. doi: 10.3109/ 0886022X. 2012. 717479.
12. C J Ribeiro R, Sales V, Neves F, Draibe S, Brandão-Neto J. Effects of Zinc on Cell-Mediated Immunity in Chronic Hemodialysis Patients. Biol Trace Elem Res. 2004; 98: 209-18. doi:10.1385/BTER:98:3:209.
13. Iseki K, Ikemiya Y, Iseki C, Takishita S. Haematocrit and the risk of developing end-stage renal disease. Nephrol Dial Transplant. 2003; 18(5): 899-905. doi:10.1093/ndt/gfg021.
14. Silverberg D, Wexler D, Blum M, Wollman Y, Iaina A. The cardio-renal anaemia syndrome: does it exist? Nephrol Dial Transplant. 2003; 18 Suppl 8:viii7-12. doi: 10.1093/ ndt/gfg1084.
15. Sharifian M, Roozbeh J, Sagheb MM, Shabani S, Hamidian Jahromi A, Afsharinai R, et al . Does zinc supplementation help in the treatment of anemia in patients on hemodialysis? Saudi J Kidney Dis Transpl. 2012; 23(4): 836-7. doi: 10.4103/ 1319-2442.98177.
16. Kobayashi H, Abe M, Okada K, Tei R, Maruyama N, Kikuchi F, et al. Oral zinc supplementation reduces the erythropoietin responsiveness index in patients on hemodialysis. Nutrients. 2015; 7(5): 3783-95. doi: 10.3390/nu7053783.
17. Prasad AS. Clinical, immunological, anti-inflammatory and antioxidant roles of zinc. Exp Gerontol. 2008; 43(5):370-7. doi:https://doi.org/10.1016/j.exger.2007.10.013
18. Mousavi SM, Djafarian K, Mojtahed A, Varkaneh HK, Shab-Bidar S. The effect of zinc supplementation on plasma C-reactive protein concentrations: A systematic review and meta-analysis of randomized controlled trials. Eur J Pharmacol. 2018;834:10-6. doi:https://doi.org/10.1016/j.ejphar.2018.07.019.
19. Rashidi AA, Salehi M, Piroozmand A, Sagheb MM. Effects of Zinc Supplementation on Serum Zinc and C-Reactive Protein Concentrations in Hemodialysis Patients. J Ren Nutr. 2009;19(6):475-8. doi:10.1053/j.jrn.2009.04.005
How to Cite
D. YOUNAN, O., K. RASHID, S., & A. MEHE, A. (2020). EFFECT OF ZINC SUPPLEMENTATION ON ANEMIA AMONG PATIENTS ON REGULAR MAINTENANCE HEMODIALYSIS. Duhok Medical Journal, 14(1), 106-113. Retrieved from https://dmj.uod.ac/index.php/dmj/article/view/122