Serum zinc and copper levels in maintenance haemodialysis patients and its relationship with depression and anxiety

Abstract

Hemodialysis (HD) patients are at risk for both deficiency, and accumulation of

trace elements, although the data remains controversial. Low serum zinc level

is associated with major depression in the general population; and copper

interferes with zinc levels since it shares the same absorption pathways as zinc.

Previous data suggest a possible zinc deficiency and copper excess is associated

with depression in haemodialysis patients. The aims of this study are to assess

depression and anxiety in HD patients using the Beck Depression Inventory and

Beck Anxiety Inventory scoring system, and, to determine the association of

serum zinc and copper levels with depression and anxiety in HD patients. A

cross sectional study was conducted on 65 Haemodialysis patients stratified

across equal numbers of study subjects relevant to age and sex; and compared

to an apparently healthy cohort of individuals over a period of 3 months. All

study subjects were analyzed for serum zinc, copper, urea, creatinine,

haemoglobin and albumin after collecting detailed demographic data. Anxiety

and depression were assessed by using the Beck Anxiety Inventory (BAI) and

Beck Depression Inventory (BDI) scoring system. The results of this study

demonstrated that 89% and 98 % of haemodialysis patients suffered from

depression and anxiety respectively. The mean levels of serum zinc and

albumin were 56.25 ± 22.85 µg/dl vs 83.8 ± 18.12 µg/dl and 3.14 ± 0.49 gm/dl vs

3.95 ± 0.37 gm/dl respectively; which were significantly decreased in HD

patients when compared to controls. A negative correlation was found

between serum zinc levels and severity of depression; but, not for anxiety in HD patients. Serum copper levels

in haemodialysis patients were indifferent from the controls (118.2 ± 41.59 µg/dl vs 102.23 ± 30 µg/dl). This

study concluded that the majority of patients undergoing chronic haemodialysis were severely depressed and

anxious. Patients on regular haemodialysis had decreased zinc levels and had more severe psychiatric

disturbances than others.