Trace Element Imbalance and Redox-Relevant Serum Profile in Hemodialysis: A Validated Multielement ICP-MS Study

Chronic kidney disease (CKD) is associated with persistent inflammation and increased oxidative stress. Trace elements play an important role in these processes as modulators of redox balance, acting either as cofactors of antioxidant systems or as potential inducers of pro-oxidant mechanisms. In this study, the serum profile of trace elements with antioxidant and pro-oxidant relevance was characterized by inductively coupled plasma mass spectrometry (ICP-MS) in hemodialysis patients. Results were compared with those from a healthy control group, and associations with biochemical and hematological parameters were explored. A cross-sectional observational study was conducted including 117 hemodialysis patients and 82 healthy controls, determining a panel of eight trace elements (Zn, Se, Cu, Mn, As, Cr, Co, and Ni). The method showed adequate sensitivity, satisfactory precision for most elements, and acceptable trueness. Hemodialysis patients exhibited significantly lower serum concentrations of Zn and Se, together with greater interindividual variability, as well as higher concentrations of elements with potential pro-oxidant effects, including As, Cr, Co, and Ni. Within this group, Zn and Se were mainly associated with markers of the protein compartment, Cu with ceruloplasmin and inflammatory markers, and Cr and Ni with parameters of renal function and vitamin D status.