Influence of haemodialysis and renal transplantation on trace element concentrations in children with chronic renal failure

Whole blood levels of Cd and Pb (microgram/g Hb), serum concentrations of Sr and Zn and their urinary excretion were measured in healthy, renal transplant and dialyzed children by atomic absorption spectroscopy. Furthermore, before and after dialysis the concentrations of these elements were determined in blood/serum as well as in the dialysis fluid. The predialytic concentrations of Cd, Pb and Sr in blood/serum were significantly increased compared to controls. Haemodialysis had only minor effects on whole blood Cd and Pb levels but serum Sr and Zn concentrations increased as a result of high metal levels in dialysis fluid. Children after renal transplantation showed no alterations in Pb, Sr and Zn concentrations compared to healthy children but whole blood Cd was increased. According to the renal function the Pb, Cd and Zn urinary excretion decreased in the following order: healthy, renal transplant and dialysis children. Sr urinary excretion was increased in haemodialysis and renal transplant patients. In conclusion, we found no Zn deficiency. Elevated blood levels of Cd and Pb and elevated Sr serum concentrations in paediatric patients undergoing dialysis and increased Cd whole blood levels in renal transplant children could be of clinical interest.