#1245 Assessment of arsenic toxicity in cigarette smokers hemodialysis patients, its correlation with anemia and metabolic bone disease and evaluation of the role of high flux hemodialysis in arsenic clearance

Abstract

Abstract Background and Aims Cigarette smoking is widely consumed worldwide. Arsenic is highly detected in cured or processed tobacco leaves at high concentrations. Arsenic poisoning can cause debilitating illness if left untreated, and its management especially in anuric patients by hemodialysis should be evaluated. 1-Assessment of Arsenic toxicity in Cigarette smokers in hemodialysis patients. 2- Assessment of correlation between Arsenic level with anaemia, uric acid and metabolic bone disease in hemodialysis patients. 3- Evaluation of the role of high flux hemodialysis in arsenic clearance. Method The study included 20 male patients on regular high flux hemodialysis for 6 months or more from Hemodialysis unit of Souad Kafafi Teaching Hospital- Egypt divided as follows: 1- Group A: 10 patients on regular active cigarette smoking. 2-Group B: 10 male non-smoker patients as control group. After taking a written consent from all participants and approval of ethical committee, the researchers drew venous blood sample (5 ml) by using metal free heparinized tube for Arsenic level pre and post hemodialysis sessions, blood samples for Complete Blood Count (CBC) including MCV, MCHC, RDW %, uric acid, Calcium total and ionized, phosphorus and magnesium. Dialysis Water samples were taken and normal Arsenic level <0.01 mg/L. All lab tests were done in Souad Kafafi central Lab except serum Arsenic level was done in Alborg central lab by Atomic Absorption Spectrometry from Perkin Elmer in Ug/dL. Results There was a highly statistically significant mean value of arsenic blood level at pre and post hemodialysis sessions in cigarette smokers group compared to non-cigarette smokers. There was also a highly statistically significant reduction in the mean value of arsenic blood level in the post-hemodialysis session compared to the pre-hemodialysis one. There was a statistically significant positive correlation between arsenic blood level pre hemodialysis session with age, years of smoking, number of cigarettes per day, RDW% and serum uric acid. While, there was a statistically significant negative correlation between arsenic blood level with hemoglobin, serum calcium, ionized calcium and serum magnesium. Conclusion Cigarette smoking increases blood arsenic level in hemodialysis patients, high flux hemodialysis is efficient in arsenic clearance, higher arsenic blood level associated with significant anaemia with high RDW%, high uric acid, low calcium and magnesium in hemodialysis patients.