Erika Stahl Rd Csr Cnsc
Erika Stahl is a Registered Dietitian and Board Certified Specialist in Renal Nutrition . Erika has been working as a dietitian for 4 years and prior to becoming a dietitian, worked as a dietetic technician registered. Erika works full time as a dialysis dietitian but also privately counsels clients with Celiac Disease on how to follow a gluten-free diet.
New Study Investigates The Effects Of Zinc Supplementation In Chronic Kidney Disease
Over the past decade chronic kidney disease has become a growing public health concern, with the two leading underlying causes of end-stage kidney disease being type II diabetes and hypertension.
In a study published last Tuesday in Nutrients, researchers investigated the effects of zinc supplementation in CKD.
Zinc is an essential trace mineral and a cofactor that impacts the structure and function of over 3000 proteins. A significant level of zinc has been found in numerous organs including the heart, liver, and kidney thus, maintaining an adequate amount of zinc is essential for optimal health and function. Zinc deficiency has been shown to exacerbate the symptoms associated with CKD. Zinc protects against oxidative stress and plays an essential role in microtubule formation and function. Although zinc requirements have not been established in CKD, it is recommended that patients receive the dietary reference intakes for this mineral.
This new study was a randomized trial consisting of 48 patients with CKD under 18 years of age. Each patient consumed either 15 mg or 30 mg of zinc supplementation per day for approximately 11 months. Assessments and laboratory biomarkers included serum zinc, body mass index , serum albumin, and C-reactive protein .
Other nutrients to consider for kidney support include fiber, resistant starch, fish oil, phosphatidylcholine, and n-acetyl-cysteine or glutathione.
Toxicity And Dosage Recommendations
Just as a deficiency in zinc can cause health complications, excessive intake can also lead to negative side effects.
The most common cause of zinc toxicity is too much supplemental zinc, which can cause both acute and chronic symptoms.
Ingesting too much zinc can also cause deficiencies in other nutrients.
For example, chronic high zinc ingestion can interfere with your absorption of copper and iron.
Reductions in copper levels have even been reported in people consuming only moderately high doses of zinc 60 mg per day for 10 weeks .
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Zinc Supplementation Potentially Beneficial To Kidney Patients On Mhd: Chinese Review
Related tags:Antioxidant
MHD acts as the mainstay of treatment for those suffering from end-stage kidney disease and who are either waiting for a renal transplantation, or simply deemed unsuitable for transplantation.
At the same time, zinc is considered an essential trace element for humans, and zinc deficiency has been linked to adverse outcomes in kidney disease.
Elemental assessment
Based on this, researchers at the Guangzhou University of Chinese Medicine Southern Medical University conducted systematic review and meta-analysis of RCTs of zinc supplementation’s effects on lipid profile and nutritional status, as well as its anti-inflammatory and antioxidant activity in MHD patients.
They subsequently observed that zinc supplementation tended to lead to higher levels of serum zinc and superoxide dismutase, greater dietary protein intake, and lower levels of C-reactive protein and malondialdehyde.
When it came to lipid profile, however, zinc supplementation did not seem to have a significant effect.
The researchers further wrote that in their meta-regression analysis, they “found that serum zinc levels correlated positively with intervention time and varied greatly by ethnicity”.
They added that the results from the Beff and Egger tests showed “no significant bias” in their meta-analysis, and that the results of the subgroup analysis supported these outcomes.
Other considerations
Zinc Is Both Good Bad For Kidney Stones Researchers Say
The nutrient zinc can be both helpful and harmful when it comes to kidney stones, a new study finds.
There have been two conflicting theories about the link between zinc and kidney stones. One suggests zinc stops the growth of the calcium oxalate crystals that make up the stones. The other suggests zinc changes the crystals’ surfaces, which encourages further growth.
Turns out both are correct, according to findings recently published in the journal Crystal Growth & Design.
“What we see with zinc is something we haven’t seen before,” said study author Jeffrey Rimer, a professor of chemical and biomolecular engineering at the University of Houston.
“It does slow down calcium oxalate crystal growth and at the same time it changes the surface of the crystals, causing defects in the form of intergrowths,” he explained in a university news release. “These abnormalities create centers for new crystals to nucleate and grow.”
Rimer referred to the situation as a proverbial double-edged sword.
To learn how zinc affects the growth of kidney stones, Rimer’s team used lab experiments and modeling. The techniques could lead to new ways to prevent kidney stones, he said.
“These are enabling tools that allow us to understand at an almost molecular level how various species in urine can regulate crystal growth,” Rimer said.
The researchers also examined how similar ions like magnesium affect kidney stone formation.
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Magnesium And Kidney Stones
Maintaining adequate magnesium levels may help prevent calcium oxalate kidney stones, the most common type. Calcium and magnesium competitively bind to oxalate. If calcium binds with oxalate, the crystals formed may lead to the formation of stones. However, if magnesium binds to oxalate, the crystals formed are more soluble and will likely not lead to stone formation. In most people the ratio of calcium and magnesium is appropriate to prevent calcium oxalate stone formation. In populations deficient in magnesium or more prone to stone formation, additional dietary or supplemental magnesium intake, along with other measures in kidney stone prevention, such as:
- adequate fluid
- may be beneficial
- Maintaining adequate magnesium levels may help prevent calcium oxalate kidney stones, the most common type.
- However, if magnesium binds to oxalate, the crystals formed are more soluble and will likely not lead to stone formation.
What Is A Kidney Stone
A kidney stone is a hard deposit of salts and minerals that form inside your kidneys. Your kidneys remove waste and fluid from your blood, which makes urine. If you don’t have enough fluid in your blood, the wastes can accumulate and form into stones. These stones can be as small a grain of salt or grow to be as big as a golf ball.
Vitamin C intake, also called ascorbic acid, has been proposed as a risk factor for kidney stones formation because vitamin C may increase urinary oxalate excretion, a type of calcium salt responsible for some stones.
“Ingested vitamin C is partly converted to oxalate and excreted in the urine, thus potentially increasing the risk of calcium oxalate stone formation,” says Dr. Malik. “In a metabolic study of 24 individuals, 2 grams daily of vitamin C increased urinary oxalate excretion by about 22%.”
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Zinc Supplementation And Cancer
Zinc is not generally considered a causative agent for cancer development. In contrast, displacement of zinc from zinc-binding structures, i.e., finger structures in DNA repair enzymes, may even be a major mechanism for carcinogenicity of other metals such as cadmium, cobalt, nickel, and arsenic. One well investigated example in which an involvement of zinc in cancer development was suggested is prostate cancer. Notably, zinc levels in prostate adenocarcinoma are significantly lower than in the surrounding normal prostate tissues, suggesting an implication of zinc in the pathogenesis and progression of prostate malignancy. Men with moderate to higher zinc intake may have a lower risk for prostate cancer, but the opposite may be true at extremely high doses and long-term supplementation.
Thedrugs And Supplements That Should Cause Concern
The following drugs andsupplements can affect kidney function:
1. NSAIDS
NSAIDs are very effectivemedications for multiple medical problems. But taking NSAIDS can affectthe kidneys, and can cause damage, especially if youre also takingdiuretics or ACE inhibitors.
NSAIDS include over-the-counterpainkillers like aspirin , ibuprofen , and naproxen .
They also includeprescription drugs like:
- Naproxen sodium .
- Naproxen/esomeprazole .
- Diclofenac .
Using these medications withcaffeine can further harm your kidneys. When taking these medications, be sureto check regularly with your doctor if you have impaired kidney function.
2. Antibiotics
Certain antibiotics areremoved from the body through the kidneys, so taking them can put extra strainon your kidneys. Penicillin, cephalosporins and sulfonamides in particular canbe harmful to your kidneys.
Long-term antibiotic use caninjure your kidneys, even if youre otherwise healthy. And for people whosekidneys arent functioning at 100% to begin with, antibiotics can build up inthe body and cause damage.
Despite this, its importantto keep in mind that antibiotics can be safely used if needed as long as thedose is adjusted for your bodys level of kidney function.
3. Dietary supplements
Certain herbs or nutritionalsupplements are associated with kidney injury, even among healthy people. Withsuch a wide variety of supplements available, the best way to know if asupplement is safe is to ask your doctor to review all the ingredients.
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Increasing Kidney Stone Cases
The prevalence of kidney stones has been rising in the United States over the last three decades. The lifetime risk of kidney stones is now approximately 19 percent in men and 9 percent in women, reports the Foundation.
Possible causes include drinking too little water, exercise , obesity, weight loss surgery, or eating food with too much salt or sugar, reports the Foundation. Infections and family history can also lead to kidney stones.
Once you have developed a first stone, as many as 50 percent of people are at risk of developing another stone within five years, said Chi. Amazingly, we have not had a new medication for the prevention of kidney stones in more than 25 years, and the medications that we do have arent completely effective.
The senior author is , MD, a professor in the UCSF School of Medicine in the Department of Urology. From UCSF, co-authors include Pankaj Kapahi, PhD, and David Killilea, PhD, of the Department of Urology Katia Bruckner, PhD, an assistant professor in the department of Cell/Tissue Biology and Anatomy and professor emeritus Arnold Kahn, PhD.
The work was funded by grants from the American Federation for Aging Research, the California Urology Foundation, and the National Institutes of Health. The research was also supported in part by a grant from the American Urological Association Foundation Research Scholars Program and the Endourgological Society.
Correlations Of Pufa And Estimates Of Desaturase Activity With Zinc Status
As shown in Table 5, no statistically significant correlations were observed between dietary zinc intake and plasma phospholipids’ levels of individual n-6 and n-3 PUFAs neither with estimated desaturase activities among HD patients. Positive correlations were found for serum zinc concentration with DGLA and D6D and inverse associations with the DGLA/LA ratio . Serum copper concentration was inversely associated with EPA . The Cu/Zn ratio and serum copper concentration directly correlated with ELO .
Table 5. Correlation between Zinc intake and status values with plasma PUFA profile and estimated desaturase activity in hemodialysis patients.
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Variation Of Plasma Zinc Levels With Ckd Stage And Associations With Egfr
Mean plasma zinc levels in participants with CKD Stage 5 were 18% lower than levels in non-CKD patients . Plasma zinc levels decreased with increasing CKD stage, as illustrated in . A Cuzicks test showed that this trend was statistically significant .
Variation of plasma zinc between CKD stages. Correlation of plasma zinc with eGFR. The line and its 95% CI represent the prediction of linear regression.
When including all individuals, plasma zinc correlated positively and linearly to eGFR , as illustrated in . However, this relationship varied according to eGFR level and CKD status. In CKD participants, the two variables were positively related for eGFR values < 60mL/min/1.73 m2, but there was no trend when the eGFR was > 60mL/min/1.73 m2. In hypertensive and normotensive controls, the two variables were positively related across the whole range of eGFR.
Link Between Zinc And Kidney Function
Deficiency of zinc can enhance the expression of certain proteins known as angiotensis II that constrict the blood vessels in kidneys and further aggravate the condition of individuals with obstructive kidney disease, according to a study published in the August 2000 issue of the journal “Kidney International.” Another study in the August 2008 issue of the “American Journal of Physiology” also reveals that low levels of zinc during pregnancy and pre- and post-weaning phases can impair the development and maturation of kidneys in the child and, in turn, increase the risk of high blood pressure and renal dysfunction in adult life.
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The Effects Of Zinc On Kidney Functions
Kidneys are a pair of bean-shaped organs located near the middle of the back. They play an important role in removing wastes from the blood and in maintaining its chemical balance. Certain health conditions such as diabetes, high blood pressure and kidney diseases reduce the functioning of the kidneys and lead to symptoms such as frequent urination, fatigue, loss of appetite, swelling in the extremities and muscle cramps. Treatment depends on the underlying cause and may include medications and surgery. Certain nutrients and minerals such as zinc play an important role in kidney function.
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When To See A Doctor
Anyone who is experiencing any of these symptoms or suspects that their job has exposed them to too much zinc should seek emergency care or call a poison control center right away.
It is also important to discuss any nutritional or vitamin supplements with a doctor before starting to take them. Doing this is especially important if a person is taking other medications or has a medical condition that the extra zinc intake could affect.
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Megadosing Vitamin C May Injure Kidneys
The megavitamin movement of the 1970s suggested that taking large doses of common vitamins would benefit health. Unfortunately, the alleged benefits may come at a price. A November 2017 update in GeneReviews states that megadosing vitamin C may lead to kidney failure. Surprisingly, even juicing with certain fruits and vegetables may cause this damage.
Many Americans use nutritional supplements to improve their health. As with vitamins, using these dietary aids increases the risk of organ damage. In fact, 1 in 12 people in the U.S. take supplements known to cause kidney damage, according to a March 15 report in the American Journal of Public Health.
Despite these risks, the Food and Drug Administration continues to leave nutritional supplements unregulated. Thus, people must take the initiative and educate themselves about the potential benefits and risks of dietary aids.
A September 2017 review in Food and Chemical Toxicology offers a starting point. This article provides a brief summary of kidney-damaging supplements. The authors suggest avoiding such dietary aids and specifically recommend avoiding excess doses of vitamins A, C and D.
Low Good Hdl Cholesterol
Good high-density lipoprotein cholesterol lowers your risk of heart disease by clearing cholesterol from your cells, thereby preventing the buildup of artery-clogging plaque.
For adults, health authorities recommend an HDL greater than 40 mg/dL. Lower levels put you at a higher risk of heart disease.
A 2015 meta-analysis found that around 40 mg of zinc a day may lower low-density lipoprotein cholesterol by 11.25 mg/dl in non-healthy individuals. Researchers report that zinc supplementation in non-healthy patients can also cause a significant elevation of HDL cholesterol.
While several factors affect cholesterol levels, these findings are something to consider if you take zinc supplements regularly.
Summary
Regular ingestion of zinc above the recommended levels can cause a drop in good HDL cholesterol levels, which may put you at a higher risk of heart disease.
1 ).
Interestingly, zinc in excess of the recommended levels may also cause taste alterations, including a bad or metallic taste in your mouth.
Typically, this symptom is reported in studies investigating zinc lozenges or liquid supplements for treating the common cold.
While some studies report beneficial results, the doses used are often well above the UL of 40 mg/day, and adverse effects are common .
If youre using zinc lozenges or liquid supplements, be aware that these symptoms may continue even during treatment .
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Icipants And Baseline Characteristics
The study population consisted of 108 patients with CKD and 81 non-CKD participants . Patients in the CKD and AH groups did not differ significantly in terms of age, gender and body mass index. Healthy volunteers were significantly younger, and more often female than CKD and AH participants.
A summary of baseline characteristics according to group is shown in .
Does Zinc Inhibit Or Promote Growth Of Kidney Stones Well Both
First Study to Validate Conflicting Theories
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A funny thing happened on the way to discovering how zinc impacts kidney stones – two different theories emerged, each contradicting the other. One: Zinc stops the growth of the calcium oxalate crystals that make up the stones and two: It alters the surfaces of crystals which encourages further growth. Now it can be told both theories are correct as reported in the America Chemical Society journal Crystal Growth & Design by Jeffrey Rimer, Abraham E. Dukler Professor of Chemical and Biomolecular Engineering at the University of Houston, who conducted the first study to offer some resolution to the differing hypotheses.
What we see with zinc is something we havent seen before. It does slow down calcium oxalate crystal growth and at the same time it changes the surface of the crystals, causing defects in the form of intergrowths. These abnormalities create centers for new crystals to nucleate and grow, reports Rimer, who refers to the effect as a double-edged sword.
The formation of kidney stones is a pathological condition that has increased in frequency among patients, leading to an increased amount of suffering and steep rise in medical costs.
In this study, Rimer and his team used a combination of in vitro experiments and computational modeling to decode the effects of zinc on COM crystal growth.
The team compared the impact of zinc on COM, with similar ions like magnesium.
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