Iron

Hemoglobin level variability is common in hemodialysis patients with chronic kidney disease. The main objective of the study was to assess the influence of combination therapy (erythropoietin + iron preparations) and monotherapy (erythropoietin) on hemoglobin levels in patients with CKD on maintenance hemodialysis. The study was conducted in 150 patients (102 (68%) males and 48 (32%) females; mean age 51 ±13.8 years) undergoing once/twice/thrice weekly maintenance hemodialysis and were prescribed with combination therapy of erythropoietin + iron preparations and monotherapy of erythropoietin. Hemoglobin levels were estimated once every month prior to hemodialysis session for a period of 5 months. Patients were regularly monitored for side effects. There were significant increases in the serum hemoglobin levels (8.5 ± 2.1 at 1st month to 9.1 ± 1.6 at 5th month) on treatment with combination therapy (p < 0.05). Combination therapy is effective than monotherapy in maintaining the hemoglobin levels (variability) in chronic kidney disease patients on maintenance hemodialysis. 

Trace elements are essential for health, growth and functioning of a number of components of the immune system. They are very important for a number of enzymes and proteins which are involved in many physiological and biochemical processes related to growth, production and reproduction. There are many trace elements which are associated with thyroid function, among which Iodine is very important  as it is the source for thyroid hormones synthesis . Selenium-containing enzymes protect the thyroid gland from oxidative stress and the selenium-based proteins help to regulate hormone synthesis, converting T4 into the more accessible and active T3. These proteins and enzymes help to regulate metabolism and maintain the right amount of thyroid hormones in the organs where it is being used. Similarly trace elements like zinc, iron and copper are vital for thyroid function. In this review, we have summarized all information available on the role of trace elements for the functioning of Thyroid gland. Some trace elements showed increased concentration in malignant and benign thyroid nodules and therefore, those trace elements can also be used as markers of thyroid cancers.