{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T05:07:59Z","timestamp":1778303279337,"version":"3.51.4"},"reference-count":31,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T00:00:00Z","timestamp":1732838400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Zinc supplementation induces metallothionein, leading to reduced serum copper levels. Conversely, serum copper concentrations tend to rise with the use of HIF-PH inhibitors. Methods: To establish a safe level of zinc supplementation that avoids copper deficiency, serum copper and zinc concentrations measured every three months were retrospectively analyzed over five years in 50 patients undergoing hemodialysis. Results: At the initiation of the study, the median (IQR) concentrations were 100 (84.25\u2013109) \u00b5g\/dL for serum copper and 60.5 (50.5\u201370) \u00b5g\/dL for serum zinc. All participants without zinc supplementation exhibited zinc deficiency (&lt;80 \u00b5g\/dL). After three months, copper deficiency (&lt;71 \u00b5g\/dL) was observed when serum copper concentrations were &lt;98.6 \u00b5g\/dL for patients with HIF-PH inhibitors and &lt;90.3 \u00b5g\/dL for patients without them. Reduced zinc supplementation may be necessary when serum copper falls below 90 \u00b5g\/dL. Zinc levels remained deficient because supplementation was limited due to concerns about copper deficiency. Lowering the target zinc level to around 80 \u00b5g\/dL instead of the conventional 80\u2013120 \u00b5g\/dL may be safer. Conclusions: Regular monitoring of both copper and zinc levels, taking place at least every three months, is recommended to adjust zinc supplementation, especially in patients on HIF-PH inhibitors. Copper supplementation should also be considered alongside zinc supplementation to effectively treat hypozincemia.<\/jats:p>","DOI":"10.3390\/nu16234135","type":"journal-article","created":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T02:57:08Z","timestamp":1732849028000},"page":"4135","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Managing Zinc Supplementation in Hemodialysis Patients: Balancing and Preventing Deficiencies in Serum Copper and Zinc Levels with and Without HIF-PH Inhibitors"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6392-8349","authenticated-orcid":false,"given":"Akira","family":"Takahashi","sequence":"first","affiliation":[{"name":"Dialysis Center, Tesseikai Neurosurgical Hospital, 28-1 Nakanohonmachi, Shijonawate 575-8511, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.jtemb.2005.01.003","article-title":"Prevalence of zinc deficiency and immune response in short-term hemodialysis","volume":"18","author":"Turan","year":"2005","journal-title":"J. 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