Long-term effects of zinc replacement therapy continuation in hemodialysis patients on mortality and nutritional indices: A posthoc analysis

= 0.041). Independent predictors of mortality included age (HR: 1.09 per year), female sex (HR: 2.46), primary kidney disease (HR: 2.81), serum albumin <3.5 g/dL (HR: 4.35), transthyretin <20 mg/dL (HR: 3.59), and phosphorus <3.7 mg/dL (HR: 3.28). Subgroup analysis revealed that albumin ≥3.5 g/dL was protective in the continuation group, while malnutrition and inflammation markers were strongly associated with mortality in the discontinuation group. Continuation of zinc replacement therapy was associated with significantly improved survival in HD patients. These findings suggest that sustained supplementation may provide prognostic benefit, particularly in those with preserved nutritional status.RegistrationThe study was registered with the University Hospital Medical Information Network (UMIN) under registration number 000038759.