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Correction of hypozincemia following liver transplantation in children is associated with reduced urinary zinc loss
Author(s) -
Narkewicz Michael R.,
Krebs Nancy,
Karrer Frederick,
OrbanEller Kathy,
Sokol Ronald J.
Publication year - 1999
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.510290322
Subject(s) - zinc , liver transplantation , zinc deficiency (plant disorder) , urinary system , medicine , chronic liver disease , transplantation , gastroenterology , liver disease , albumin , endocrinology , creatinine , pathology , micronutrient , chemistry , cirrhosis , organic chemistry
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.