Aldalati Abdullah Yousef, Hussein Ayham Mohammad, Balbaa Elsayed, Alrabadi Bassel, Albliwi Moath, Abuassi Mohammad, Rawashdeh Badi
Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Faculty of Medicine, Al-Balqa' Applied University, Salt, Jordan.
Biol Trace Elem Res. 2025 Apr 30. doi: 10.1007/s12011-025-04647-5.
Copper is an essential trace element involved in numerous enzymatic functions and physiological processes. Chronic kidney disease (CKD) and hemodialysis (HD) may influence copper homeostasis, yet conflicting findings exist regarding copper levels in these patients and copper levels aren't routinely checked. This systematic review and meta-analysis evaluates serum copper concentrations in CKD and HD patients compared to healthy controls (HC), and assesses changes pre- and post-HD.
A systematic search of PubMed, Scopus, Cochrane Library, EMBASE, and Web of Science was conducted up to February 2025. Observational studies reporting serum copper levels in CKD and HD patients were included. Data analysis were conducted using RevMan software. The data were pooled as standardized mean difference (SMD) and using a random-effects model.
A total of 42 studies with 13,592 participants were included. No significant difference in copper levels was observed between CKD patients and HC (SMD: -0.18, 95% CI: -1.17, 0.80; P = 0.71). However, HD patients had significantly lower copper levels compared to HC (SMD: -0.48, 95% CI: -0.89, -0.07; P = 0.02). Additionally, HD significantly reduced serum copper levels post-treatment compared to pre-HD (SMD: -0.41, 95% CI: -0.62, -0.21; P < 0.0001).
Our findings suggest that CKD does not significantly impact serum copper levels, whereas HD leads to a significant decrease in copper concentrations. The mechanisms underlying this reduction require further elucidation, and future studies should explore the potential clinical consequences of low copper levels in HD patients.
铜是一种必需的微量元素，参与众多酶促功能和生理过程。慢性肾脏病（CKD）和血液透析（HD）可能会影响铜稳态，但关于这些患者的铜水平存在相互矛盾的研究结果，且铜水平并非常规检测项目。本系统评价和荟萃分析比较了CKD和HD患者与健康对照（HC）的血清铜浓度，并评估了HD治疗前后的变化。
截至2025年2月，对PubMed、Scopus、Cochrane图书馆、EMBASE和科学网进行了系统检索。纳入报告CKD和HD患者血清铜水平的观察性研究。使用RevMan软件进行数据分析。数据合并为标准化均数差（SMD），并采用随机效应模型。
共纳入42项研究，13592名参与者。CKD患者和HC之间未观察到铜水平的显著差异（SMD：-0.18，95%CI：-1.17，0.80；P = 0.71）。然而，与HC相比，HD患者的铜水平显著降低（SMD：-0.48，95%CI：-0.89，-0.07；P = 0.02）。此外，与HD治疗前相比，HD治疗后血清铜水平显著降低（SMD：-0.41，95%CI：-0.62，-0.21；P < 0.0001）。
我们的研究结果表明，CKD不会显著影响血清铜水平，而HD会导致铜浓度显著降低。这种降低的潜在机制需要进一步阐明，未来的研究应探索HD患者低铜水平的潜在临床后果。
