The Relationship Between Nephrotoxic Serum Trace Elements and Renal Function Tests in Diabetic Nephropathy

Abstract

Background

Diabetic nephropathy (DN) is a leading cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD), with oxidative stress and trace element imbalances playing a significant role in its progression. This study investigates the relationship between nephrotoxic serum trace elements and renal function tests (RFT) in DN patients.

Methods

A cross-sectional study was conducted on 123 participants divided into four groups: diabetic patients without nephropathy (n=25), kidney disease patients without diabetes (n=22), diabetic nephropathy patients (n=20), and healthy controls (n=56). Serum levels of essential trace elements (iron, zinc, copper, magnesium) and nephrotoxic elements (arsenic, lead, mercury, cadmium) were analyzed using inductively coupled plasma mass spectrometry (ICP-MS). Renal function markers, including urea, creatinine, and blood urea nitrogen (BUN), were assessed. Statistical analyses included ANOVA, Pearson’s correlation, and multivariate regression.

Results

Diabetic nephropathy patients exhibited significantly higher creatinine (92.8 ± 44.34 µmol/L, p<0.0001) and urea levels compared to other groups. Magnesium showed significant positive correlations with sodium (r=0.490, p<0.05), potassium (r=0.605, p<0.01), and calcium (r=0.539, p<0.05), while iron negatively correlated with uric acid (r=-0.520, p<0.05).

Conclusion

Magnesium and iron play a crucial role in DN pathophysiology, with their dysregulation linked to renal dysfunction. Monitoring trace element levels could aid in DN management and early intervention strategies.