Abstract: Objectives  To investigate the association between blood trace elements and micro-inflammatory state in maintenance hemodialysis (MHD) patients. Method This was a single-center and cross-sectional study. Patients undergoing MHD within September, 2019 in our center were enrolled in this study. Demographic, clinical data and blood samples were collected before hemodialysis session. Routine blood tests, serum biochemical parameters and blood trace elements were measured. According to hs-CRP level, patients
were divided into micro-inflammatory state group (hs-CRP 3～15mg/L) and control group (hs-CRP＜3mg/L).
Spearman analyses and binary logistic regression were performed to study the relationship between blood
trace elements and micro- inflammatory state. Results A total of 128 MHD patients were enrolled in this
study, including 65 patients in the micro-inflammatory state group and 63 patients in the control group. Spearman analyses showed that the levels of serum hs-CRP and IL-6 were positively correlated with the blood copper level (r=0.530 and 0.427, respectively; P＜0.001). Multivariate logistic regression showed that elevated
level of blood copper and blood copper ≥810.60μg/L were independently associated with the micro-inflammatory state (OR=1.008, 95% CI: 1.004～1.012, P＜0.001; OR=7.406, 95% CI: 3.080～17.807, P＜0.001). Conclusion Elevated blood copper was independently associated with the micro-inflammatory state in MHD patients, indicating the necessity of blood copper monitoring in MHD patients.

Key words: Whole blood copper, Micro-inflammatory state, Maintenance hemodialysis