Correction of hypozincemia following liver transplantation in children is associated with reduced urinary zinc loss

Authors

  • Michael R. Narkewicz B290, 1056 East 19th Ave.,

    Corresponding author
    1. Departments of Pediatrics urine zinc/creatinine ratio (urine Zn/Cr; μg zinc/mg creatinine) were University of Colorado School of Medicine and The Children's Hospital, Denver, CO
    • Denver, CO 80218. fax: 303-764-8025
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  • Nancy Krebs,

    1. Departments of Pediatrics urine zinc/creatinine ratio (urine Zn/Cr; μg zinc/mg creatinine) were University of Colorado School of Medicine and The Children's Hospital, Denver, CO
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  • Frederick Karrer,

    1. Surgery, Pediatric Clinical Research Center, The Pediatric Liver Center, University of Colorado School of Medicine and The Children's Hospital, Denver, CO
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  • Kathy Orban-Eller,

    1. Surgery, Pediatric Clinical Research Center, The Pediatric Liver Center, University of Colorado School of Medicine and The Children's Hospital, Denver, CO
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  • Ronald J. Sokol

    1. Departments of Pediatrics urine zinc/creatinine ratio (urine Zn/Cr; μg zinc/mg creatinine) were University of Colorado School of Medicine and The Children's Hospital, Denver, CO
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Abstract

Zinc deficiency is a relatively common problem in children with chronic liver disease. We have previously shown inappropriate urinary zinc excretion in children with chronic liver disease and hypozincemia. This study was designed to determine if zinc deficiency and inappropriate urinary zinc losses are corrected in children with liver disease by liver transplantation. Thirty-three patients (age 1-19 years) underwent 35 liver transplants for acute and chronic liver disease. At the time of transplant, 17 patients had low plasma zinc (hypozincemic) (plasma zinc, 45.4 ± 1.8 μg/dL), whereas 18 had normal plasma zinc (75.7 ± 3.8). Before transplant, patients with zinc deficiency had higher urinary zinc to creatinine ratio compared with those with normal zinc status (6.6 ± 1.9 vs. 2.2 ± 0.6; P = .03) and lower serum albumin concentrations (low: 2.8 ± 0.1 vs. normal: 3.3 ± 0.2; P = .02). After transplant, there was a significant reduction in urinary zinc losses in the hypozincemic group followed by normalization of plasma zinc levels by 7 days posttransplant. These data suggest that the abnormal renal zinc homeostasis that is present in approximately 50% of pediatric patients undergoing liver transplant is rapidly improved and biochemical zinc deficiency is reversed after liver transplantation.

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