EFFECT OF HEMODIALYSIS ON RUBIDIUM LEVELS IN PATIENTS WITH END-STAGE RENAL DISEASE
Keywords:
rubidium, CKD, end-stage renal disease (ESRD), hemodialysis (HD), depressionAbstract
Chronic kidney disease (CKD) is becoming a leading cause of death globally, and it is estimated to rank as the fifth most common chronic disease in the next two decades, which highlights its immense social impact. The worldwide epidemiology of end-stage renal disease (ESRD) is influenced by various factors such as genetic, environmental, lifestyle, and sociodemographic traits of each country. Currently, hemodialysis (HD) stands as the leading choice for renal replacement therapy in managing advanced kidney disease. This vital treatment significantly reduces uremic toxicity, enabling the body to operate effectively when the kidneys cannot eliminate accumulated metabolic waste products. HD presents a significant risk of alterations in trace element (TE) levels. Nevertheless, it undeniably enhances the quality of life and well-being of patients. While selenium and zinc deficiencies have traditionally been the focus of scientific discussion, emerging studies have brought to the forefront another trace element that is increasingly considered essential: rubidium (Rb). Recent research indicates that a deficiency in rubidium is associated with chronic inflammatory state conditions and "uremic depression" in patients with CKD. There is limited data regarding the Rb status in the Bulgarian population, particularly among patients undergoing HD. Objectives: To investigate the possibility of a rubidium deficiency state in patients with end-stage renal disease on long-term hemodialysis, as well as to evaluate the rubidium status of patients before and immediately after the treatment procedure. Material and methods: Inductively coupled plasma mass spectrometry (ICP-MS) method has been applied for the quantification of the trace element Rb in the whole blood of a total of 60 hospitalized patients diagnosed with CKD who are undergoing maintenance hemodialysis (HD group). Additionally, a control group (CG) comprising 60 healthy individuals has been established for comparative analysis. Results: Our data revealed significant differences in Rb concentrations between the control group and the hemodialysis group (p < 0.05). Within the HD group, we observed a notable change in Rb levels before and immediately after hemodialysis, with levels measuring 1207.53 ± 305 µg/L before treatment and 1132.79 ± 268 µg/L after treatment (p < 0.05). However, we did not find any correlation between Rb concentrations and the duration of hemodialysis treatment (p = 0.834). Conclusion: Our findings, along with the association between rubidium and depression, underscore the importance of closely monitoring rubidium levels in patients with chronic kidney disease, particularly those undergoing long-term dialysis treatment. It is essential to implement the necessary precautions to prevent any potential elemental imbalances.
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