Pancytopenia with erythropoiesis-stimulating agent (ESA) hyporesponsiveness due to copper deficiency in a patient undergoing maintenance hemodialysis

Copper deficiency can cause cardiovascular lesions in experimental animals. Previous experiments have shown that the biochemical and itDrphologic lesions induced by deprivation of dietary copper can be suppressed by feeding diets containing starch or can be magnified by a high sucrose diet. In a recent study it was found that the more severe signs of copper deficiency in rats fed sucrose as compared to starch were due to the fructose moiety of sucrose. Although fructose as compared to starch markedly enhanced the symptoms of copper deficiency, the possibility that an effect of dietary carbohydrates due to the nature of the simple carbohydrate (fructose vs glucose) cannot be excluded. The present study was designed to determine if the severity of copper deficiency in rats fed sucrose as compared to starch is due to the glucose as well as the fructose moiety of sucrose. This portion of the study assessed the morphologic changes in aortas of seventy weanling male rats who were fed, for 9 weeks, copper deficient or copper supplemented diets containing either 62% starch, fructose or glucose. The starch-fed copper supplemented group served as the most normal controls. Rats were sacrificed after 9 weeks of dietary treatments. Copper deficiency was verified by reduced serum ceruloplasmin activity and serum and hepatic copper concentration.

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Abstract #337: A Rare Case of Copper Deficiency and Celiac Disease

Endocrine Practice ◽

10.1016/s1530-891x(20)44083-2 ◽

2006 ◽

Vol 12 ◽

pp. 96-97

Author(s):

Mihaela Cosma ◽

Daniel L. Hurley

Keyword(s):

Celiac Disease ◽

Rare Case ◽

Copper Deficiency

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Serum Thiamine Values in End-Stage Renal Disease Patients under Maintenance Hemodialysis

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000242 ◽

2015 ◽

Vol 85 (5-6) ◽

pp. 348-355 ◽

Cited By ~ 2

Author(s):

Masamitsu Ubukata ◽

Nobuyuki Amemiya ◽

Kosaku Nitta ◽

Takashi Takei

Keyword(s):

Thiamine Deficiency ◽

Risk Index ◽

Nutritional Risk ◽

Maintenance Hemodialysis ◽

Dialysis Patients ◽

Significant Difference ◽

Nutritional Risk Index ◽

Serum Aspartate Aminotransferase ◽

Stage Renal Disease ◽

End Stage

Abstract. Objective: Hemodialysis patients are prone to malnutrition because of diet or many uremic complications. The objective of this study is to determine whether thiamine deficiency is associated with regular dialysis patients. Methods: To determine whether thiamine deficiency is associated with regular dialysis patients, we measured thiamine in 100 patients undergoing consecutive dialysis. Results: Average thiamine levels were not low in both pre-hemodialysis (50.1 ± 75.9 ng/mL; normal range 24 - 66 ng/mL) and post-hemodialysis (56.4 ± 61.7 ng/mL). In 18 patients, post-hemodialysis levels of thiamine were lower than pre-hemodialysis levels. We divided the patients into two groups, the decrease (Δthiamine/pre thiamine < 0; - 0.13 ± 0.11) group (n = 18) and the increase (Δthiamine/pre thiamine> 0; 0.32 ± 0.21)) group (n = 82). However, there was no significance between the two groups in Kt/V or type of dialyzer. Patients were dichotomized according to median serum thiamine level in pre-hemodialysis into a high-thiamine group (≥ 35.5 ng/mL) and a low-thiamine group (< 35.4 ng/mL), and clinical characteristics were compared between the two groups. The low-thiamine value group (< 35.4 ng/ml; 26.8 ± 5.3 ng/ml) exhibited lower levels of serum aspartate aminotransferase and alanine aminotransferase than the high-thiamine value group (≥ 35.4 ng/ml; 73.5 ± 102.5 ng/ml) although there was no significance in nutritional marker, Alb, geriatric nutritional risk index , protein catabolic rate and creatinine generation rate. Conclusion: In our regular dialysis patients, excluding a few patients, we did not recognize thiamine deficiency and no significant difference in thiamine value between pre and post hemodialysis.

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