PREVALENCE OF ZINC DEFICIENCY AND OXIDATIVE STRESS IN PEDIATRIC KIDNEY TRANSPLANTATION RECIPIENTS

Background: Zinc (Zn) is a cofactor of essential enzymes involved in the antioxidant defense system. Increased oxidative stress affects the function of the transplanted kidney. Objectives: We aimed to determine the prevalence of Zn deficiency and evaluate the relationship between Zn deficiency and oxidative stress. Additionally, we investigated the associated oxidative stress factors among pediatric kidney transplant recipients. Methods: In this cross-sectional descriptive study, we enrolled children (1 to 21 years of age) who underwent kidney transplantation and were actively followed up at Phramongkutklao Hospital, Bangkok, Thailand, between December 2022 and May 2023. Patients’ characteristics were reviewed; blood samples were collected for serum zinc (Zn) level, superoxide dismutase (SOD), malondialdehyde (MDA), lipid profile, hemoglobin A1C, fasting blood sugar, and serum creatinine. Results: Twenty-four patients were included in the study. No differences in baseline characteristics between the two groups were observed. Zn deficiency was identified in eight patients. The prevalence of Zn deficiency in pediatric kidney transplant recipients was 33.33% (95% CI: 15.6%-55.3%). The median Zn level in the patients with and without Zn deficiency was 67 (49-72) and 83 (74-111) mcg/ dL, respectively. The median percentage of Zn intake per dietary reference intake (DRI) in Zn-deficient patients was 88.57 (47.56-115.8) compared with 97.5 (62.89-120.6) in the non-Zn-deficient group. However, these were not statistically significant. One patient (1/1, 100%) who had a history of chronic allograft rejection revealed a significantly high SOD level in red blood cells (RBC) (p=0.026). Six patients with dyslipidemia (6/6, 100%), on the other hand, exhibited low SOD level in RBC (p=0.034). Conclusion: We could not demonstrate an association between Zn deficiency and SOD or MDA levels. Regarding a role in pediatric kidney transplantation, Zn supplementation may benefit patients with low Zn intake.