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Abstract: PO0462

Effect of Zinc Deficiency on CKD Progression and Effect Modification by Hypoalbuminemia

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Tokuyama, Atsuyuki, Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Okayama, Japan
  • Kanda, Eiichiro, Department of Medical Science, Kawasaki Medical School, Kurashiki, Okayama, Japan
  • Itano, Seiji, Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Okayama, Japan
  • Kondo, Megumi, Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Okayama, Japan
  • Wada, Yoshihisa, Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Okayama, Japan
  • Kadoya, Hiroyuki, Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Okayama, Japan
  • Kidokoro, Kengo, Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Okayama, Japan
  • Nagasu, Hajime, Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Okayama, Japan
  • Sasaki, Tamaki, Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Okayama, Japan
  • Kashihara, Naoki, Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Okayama, Japan
Background

Serum zinc (Zn) levels tend to be low in chronic kidney disease (CKD) patients. However, it has not been shown whether zinc deficiency itself leads to poor renal prognosis. The purpose of this study was to investigate the relationship between zinc deficiency and CKD progression.

Methods

This is a retrospective cohort study using the CKD patient database of electronic medical records (n=325). The study patients were classified into two groups: Zn levels<60µg/dl (low-Zn group, n=163) and Zn levels≥60µg/dl (high-Zn group, n=162). The primary outcome was defined as end-stage kidney disease (ESKD) or death, and the observation period was one year. The relationship between low Zn levels and the outcome was assessed using Cox proportional hazard model and by competitive risk analysis. Furthermore, the propensity score-matched analysis for low Zn level was also conducted.

Results

Among the subjects, 51.7% were male; mean age, 69.3years; mean Zn level, 59.9µg/dl; and median eGFR, 20.4ml/min/1.73 m2. The incidence of the primary outcome was higher in the low-Zn group than in the high-Zn group (42.3% vs 19.1%, p<0.001). The risk of the primary outcome was higher in the low-Zn group [adjusted hazard ratio (HR) 1.88 (95% CI 1.08, 3.28; p=0.025)]. The analysis using competitive risk models showed that low Zn levels were associated with ESKD, but not with death. Moreover, in the propensity score-matched analysis, the low-Zn group showed a high risk of the primary outcome [HR 2.05 (95%CI, 1.09, 3.86; p=0.026)]. Furthermore, the relationship between the low Zn levels and the primary outcome was aggravated in the hypoalbuminemia patients (interaction p=0.011).

Conclusion

This study indicated that zinc deficiency is a risk factor for ESKD among CKD patients. Hypoalbuminemia affects the CKD progression due to zinc deficiency.