Magnesium and zinc status in patients
with chronic renal failure:
influence of a nutritional intervention
Cristina Sánchez
1
, Pilar Aranda
1
, Antonio Pérez de la Cruz
2
, Juan Llopis
1
1
Institute of Nutrition and Food Technology and Department of Physiology, School
of Pharmacy, Cartuja Campus, University of Granada;
2
Servicio de Nutrición y Dietética,
Hospital Universitario Virgen de las Nieves, Granada, Spain
Correspondence: J. Llopis, Departamento de Fisiología, Facultad de Farmacia, Campus Cartuja, Universidad de
Granada, 18071 Granada, Spain
<jllopis@ugr.es>
Abstract. Chronic renal failure (CRF) alters the metabolism for a number of ele-
ments, and can lead to deficiency of these nutrients. Among the causes of these
alterations are reduced food intake and the low element content of some low-
protein diets recommended in CRF. This study aimed to determine whether nutri-
tional status for magnesium and zinc were changed by a nutritional intervention
providing patients with CRF with enough information to prepare a low protein diet
that met their needs. The effects of the intervention were compared in 40 adult par-
ticipants divided into two groups. The control group consumed their usual pre-
scribed diet, and the nutritionally instructed group received dietary training to
teach them how to choose foods that met their nutritional needs. The study period
lasted 12 months. Food consumption was assessed by 24-h recall. Magnesium and
zinc were measured in plasma at the start and at the end of the study. Participants
in the nutritionally instructed group decreased their protein intake and increased
that of carbohydrates, magnesium and zinc. Plasma zinc correlated with glomerular
filtration rate, measured as creatinine clearance, (r = 0.37) plasma protein (r = 0.39)
and zinc intake (r = 0.63). At the start of the study 1 participant in the control group
and no participants in the instructed group had hypomagnesaemia (< 1.8 mg/dL)
whereas 2 participants in the control group, and 5 in the instructed group had hypo-
zincaemia (Zn < 70 μg/dL). After the intervention we observed no changes in the
number of participants with hypomagnesaemia in either group, whereas hypozin-
caemia was found in only 1 participant in the control group and 1 in the instructed
group (changes in the instructed group were significant; p < 0.05). Nutritional inter-
vention benefited our participants by improving their ability to choose foods that
provided magnesium and zinc while reducing their protein intake. The results of
this study indicate that the dietary intervention enabled participants to better con-
trol their protein intake and zinc status without detriment to magnesium status.
Key words: chronic renal failure, magnesium, zinc, nutritional status, nutritional
intervention
Chronic renal failure (CRF) provokes imbal-
ances of elemental status in physiological fluids
and tissues [1], and can lead to deficiency in or
raised levels of these nutrients, but the mechan-
isms responsible for these changes are poorly
understood, and the contribution of toxicity or
deficiency in some elements to the symptoms of
CRF is uncertain. Among the causes of these
alterations are reduced food intake and the low
element content of some low-protein diets recom-
mended in CRF to delay the progression of kidney
damage [2, 3].
doi: 10.1684/mrh.2009.0170
Magnesium Research 2009; 22 (2): 72-80 ORIGINAL ARTICLE
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