Influence of zinc on growth and bone maturation in children with end stage renal disease (ESRD)

Children with ESRD, age 5-19 years, were supplemented with zinc acetate (2 mg/kg BW, maximum 40 mg/da/child) to determine if zinc supplements (ZS) would improve growth and bone maturation. Twelve children completed the study. Three of the 12 did not receive ZS. Seven of the 9 ZS children were followed for 1 year pre- and 1 yr during-ZS. Two subjects were followed for shorter periods of time. Heights, weights, and hand wrist radiographs were taken at the beginning of the study, just pre-ZS, and at the end of the study. Blood was analyzed for serum alkaline phosphatase and albumin monthly. Alkaline phosphatase was elevated in 7 of 12 subjects pre-ZS and in 5 of 9 subjects post-ZS. Albumin levels were below normal in 7 subjects pre-ZS and 4 subjects post-ZS. Mean plasma Zn and Cu levels, 97+/-17 and 164+/-42 mcg/dl, pre-ZS, and 102+/-30 and 173+/-46 mcg/dl post-ZS, respectively, were similar. Growth velocity in males (4.1+/-2.2 cm/yr, 3.0+/-2.3 cm/yr) and females (3.9+/-0.7, 3.3+/-2.1 cm/yr) pre- and post-ZS, respectively, were similar. Bone maturation per chronological age improved after ZS in 4 of 6 subjects, 1 matured at the same rate, and one at a slower rate. It appears that ZS of children with ESRD increased the rate of bone maturation but not linear growth