The efficacy and safety of zinc gluconate supplementation on quality of life, sleep quality, and serum albumin in hemodialysis patients: A randomized clinical trial

Chronic kidney disease (CKD) is a condition where the removal of waste products, hemostasis of electrolytes, activation of vitamin D, and regulation of blood pressure are impaired. To compensate impaired renal function, waste products and excess water are removed from the blood through dialysis, including hemodialysis and peritoneal dialysis. Although hemodialysis mimics some functions of the kidney, it is not as effective as normal kidney. Indeed, patients on hemodialysis suffer from several problems, including decreased level of albumin, poor sleep quality, and low quality of life. Hemodialysis patients usually have less albumin than healthy individuals due to increased albumin excretion during hemodialysis. Also, synthesis of albumin is decreased in response to high inflammation and malnutrition among hemodialysis patients. Moreover, malnutrition is a cause of albumin synthesis reduction. Studies showed that some nutrients, such as zinc, may have favorable effect on albumin level, for instance, zinc supplementation resulted in increment of albumin in sever zinc deficient subjects. Poor sleep quality is another problem among hemodialysis patients. Another common problem in hemodialysis patients is low quality of life, which tends to be lower than healthy counterparts. Evidence confirm that zinc deficiency is prevalent among hemodialysis patients. Although zinc supplementation could putatively improve albumin level, sleep quality, and quality of life in previous studies, there is limited evidence regarding hemodialysis patients. Additionally, most previous studies used zinc supplement in the form of zinc sulfate, whilst the effect of zinc gluconate, a more digestible with less side effects form of zinc supplement, has not been examined.

慢性肾病（CKD）是一种影响废物排泄、电解质止血、维生素D激活及血压调节等功能受损的疾病。为补偿受损的肾功能，通过透析（包括血液透析和腹膜透析）从血液中移除废物和多余水分。尽管血液透析模拟了肾脏的部分功能，但其效果不如正常的肾脏。事实上，接受血液透析的患者常常遭受多种问题，包括白蛋白水平下降、睡眠质量不佳以及生活质量降低。由于血液透析过程中白蛋白排泄增加，血液透析患者的白蛋白水平通常低于健康个体。此外，由于高炎症和营养不良，血液透析患者的白蛋白合成减少。此外，营养不良是白蛋白合成减少的原因之一。研究表明，某些营养素，如锌，可能对提高白蛋白水平具有积极作用，例如，在严重锌缺乏的受试者中，锌补充剂导致白蛋白水平升高。睡眠质量不佳是血液透析患者面临的另一问题。在血液透析患者中，生活质量低下也是一个常见问题，其水平往往低于健康人群。证据表明，锌缺乏在血液透析患者中普遍存在。尽管在先前的研究中，锌补充剂可能有助于提高白蛋白水平、睡眠质量和生活质量，但关于血液透析患者的相关证据有限。此外，大多数先前的研究使用了硫酸锌形式的锌补充剂，而葡萄糖酸锌这种更易消化、副作用更少的锌补充剂的效果尚未得到检验。