الفهرس 
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Abstract
Zinc is an essential mineral that is needed for the proper growth and maintenance of the human body. It also supports healthy immune system and necessary to synthesize DNA, also essential for wound healing and Supports the healthy growth and development of the body during adolescence, childhood and pregnancy.
Zinc is found in all parts of the body: it is in organs, tissues, bones, fluids and cells. Muscles and bones contain most of the body’s zinc, though the actual amount of zinc necessary to support the human body is quite small, its effects on the body are very important.
It is suggested that zinc deficiency in HD patients is linked to many uremic symptoms including anorexia and impaired sense of taste and smell. Decreased dietary intake and intestinal absorption, as well as increased body losses could lead to Zn deficiency in uremia.
Many studies have shown a high prevalence of zinc deficiency in CKD patients who were under either conservative or dialysis treatment.
The main clinical effects of zinc deficiency are impaired growth and development. This was proved by a study of zinc supplementation to small for gestational age infants, they show better weight and linear growth. It is generally assumed that zinc is non toxic because of the strong homeostatic regulation of the processes controlling the absorption and secretion of this mineral.
Leptin is a small peptide hormone that is mainly but not exclusively, produced in adipose tissue. The circulating leptin concentration therefore directly reflects the amount of body fat.
Although serum leptin concentration vary considerably among individuals, several finding indicate that leptin secretion is mainly correlated with body fat content and sex, being higher in obese than lean individuals and in female than in males. Leptin plasma values have been found to be reduced in malnourished patients.
Protein energy malnutrition is common in chronic renal failure (CRF) and is associated with increased mortality and morbidity. Serum leptin level has been found to be high in patients with CRF, and this outcome is thought to be related to malnutrition, changes in body composition decrease in renal clearance hemodialysis patients and erythropoietin level, and chronic inflammation in patients on hemodialysis, so there is a relationship between zinc and leptin levels in heamodialysis patients.
Our aim was to determine the effects of Zinc supplementation on serum zinc and leptin levels in patients with end stage renal disease on regular hemodialysis.
Prospective clinical trial study was conducted on 42 pediatric patients (divided into two groups: patient group and control group). The patient group was on regular hemodialysis in the pediatric dialysis unit in Monoufia University Hospitals. The patients were receiving three sessions/week at least six months.
Serum zinc level and leptin were assessed before and after intervention. Zinc was supplemented twice daily one hour before or after meal in a dose 50mg/day for 3 months
The results showed that zinc supplementation improve serum zinc level and decrease serum leptin hormone among studied patients.
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Zinc was correlated, leptin was correlated and we concluded that serum zinc level is low and serum leptin level is high in chronic kidney disease patients under dialysis treatment. Zinc supplementation increases serum zinc and decrease serum leptin among males and females in the studied patients. Improvement of serum zinc level leads to improve appetite and stimulate food intake.
We recommended that all patients suffering from chronic renal failure and receiving hemodialysis should be supplemented with zinc in a dose according to their age and sex as they have low zinc level. This zinc supplementation will improve appetite and stimulate food intake leading to increase weight and body mass index. More studies were needed to clarify the mechanism by which serum leptin level is influenced as a result of zinc supplementation in hemodialysis patients. More studies are needed to estimate the exact daily requirement needed to prevent zinc deficiency in pediatric HD patients.