The association between hypozincemia and aortic stenosis prevalence in hemodialysis patients: a single-center cross-sectional study

Background Hypozincemia contributes to phosphate-induced vascular calcification in model animals of renal failure, but the association between hypozincemia and aortic stenosis (AS) prevalence in patients with end-stage kidney disease remains unreported in clinical settings. Methods To investigate the association between hypozincemia and AS prevalence in patients undergoing hemodialysis, we designed a single-center cross-sectional study. Our outcome "AS" was defined as prevalence of moderate or severe AS or surgical history for AS. Depending on serum zinc levels, we divided patients undergoing hemodialysis into deciles. The association between hypozincemia and AS prevalence was analyzed via logistic regression adjusted for age, sex, dialysis vintage, diabetes history, serum albumin, and history of taking calcium-containing phosphate binder. Results Ninety-three patients undergoing hemodialysis were eligible. The mean serum zinc level was 61.3 [+ or -] 13.9 [mu]g/dL. Twelve patients who belonged to 1st decile had serum zinc levels [less than or equai to] 48 [mu]g/dL. Of these twelve patients, six patients (50 %) had AS. On the other hand, of eighty one patients who belonged to 2nd-10th deciles (serum zinc levels > 48 [mu]g/dL), thirteen patients (16 %) had AS. Hypozincemia (serum zinc levels [less than or equai to] 48 [mu]g/dL) was associated with AS prevalence (P = 0.038; odds ratio 4.43; 95% confidence interval 1.09-18.0). Conclusions AS was more prevalent in patients undergoing hemodialysis with severe hypozincemia in our cross-sectional study, although interventional studies are required to elucidate the benefit of zinc supplementation for AS progression. Keywords: Aortic stenosis, Cross-sectional study, Patients undergoing hemodialysis, Hypozincemia, Vascular calcification