Selenium deficiency in dialysis patients

Document Type : Research Paper

Authors

1 Associate professor, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Assistant professor, Research Center for Patient Safety, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Introduction: Trace elements deficiencies are reported in dialysis patients. We aimed to define the frequency of Selenium deficiency in dialysis patients and its correlation with age, gender, duration of dialysis, dialysis modality, and serum levels of blood urea nitrogen (BUN), albumin, total cholesterol and hemoglobin.
Materials and methods: Patients under dialysis in dialysis sections of Dr.Sheikh hospital from April 2017 to April 2019 were enrolled the study after taking written consent from patients or their parents. Blood samples were obtained for measurement of serum Selenium levels at time of routine monthly sampling.
Results: Forty patients enrolled the study .Totally 45% were under hemodialysis and 55% peritoneal dialysis .The ages in first and second groups were 12.77±2.94 and 9.34 ±4.03 years, respectively (P= 0.04) .Serum selenium levels in hemodialysis and peritoneal dialysis patients were 91.95 ±8.43 and 94.1 ± 8.67 microgram (µgr) per liter, respectively (P= 0.374). Thirteen cases (32.5%) including 38.9% of hemodialysis and 27.3% of peritoneal dialysis patients had Selenium deficiency (P= 0.435). No correlation were found between age, gender, modality of dialysis, dialysis duration , serum levels of BUN , albumin , total cholesterol and hemoglobin with Selenium deficiency (P> 0.05 for all ) .
Conclusion: Selenium deficiency is common in dialysis patients. Demographic factors , dialysis modality , dialysis duration , serum levels of BUN , albumin , total cholesterol and hemoglobin are not related with presence of Selenium deficiency .Periodic checking of serum levels of Selenium is recommended

Keywords


1) Kalantar-Zadeh K, Kopple JD. Trace elements and vitamins in maintenance dialysis patients. Advances in
renal replacement therapy 2003; 10(3):170-82.
2) Bogye G, Tompos G, Alfthan G. Selenium depletion in hemodialysis patients treated with polysulfone
membranes. Nephron 2000; 84(2):119-23.
3) Blendis LM, Ampil M, Wilson DR, Kiwan J, Labranche J, Johnson M, et al. The importance of dietary protein
in the zinc deficiency of uremia. The American journal of clinical nutrition 1981; 34(12):2658-61.
4) Mahajan SK, Prasad AS, Rabbani P, Briggs WA, McDonald FD. Zinc deficiency: a reversible complication
of uremia. The American journal of clinical nutrition 1982; 36(6):1177-83.
5) Erten Y, Kayatas M, Sezer S, Ozdemir F, Ozyigit P, Turan M, et al., editors. Zinc deficiency: prevalence and
causes in hemodialysis patients and effect on cellular immune response. Transplant Proc 1998; 30 (3):850-1.
6) Bodnar M, Konieczka P, Namiesnik J. The properties, functions, and use of selenium compounds in living
organisms. Journal of Environmental Science and Health 2012; 30(3):225-52.
7) Sandstead HH. Trace elements in uremia and hemodialysis. Am J Clin Nutr 1980; 33(7):1501-8.
8) Thomson NM, Stevens BJ, Humphery TJ, Atkins RC. Comparison of trace elements in peritoneal dialysis,
hemodialysis, and uremia. Kidney Int 1983; 23(1):9-14.
9) Padovese P, Gallieni M, Brancaccio D, Pietra R, Fortaner S, Sabbioni E, et al. Trace elements in dialysis fluids
and assessment of the exposure of patients on regular hemodialysis, hemofiltration and continuous ambulatory
peritoneal dialysis. Nephron 1992; 61(4):442-8.
10)Zima T, Tesar V, Mestek O, Nemecek K. Trace elements in end-stage renal disease. Methodological aspects
and the influence of water treatment and dialysis equipment. Blood purification 1999; 17(4):182-6.
11) Tonelli M, Wiebe N, Hemmelgarn B, Klarenbach S, Field C, Manns B, et al. Trace elements in hemodialysis
patients: a systematic review and meta-analysis. BMC medicine 2009; 7:25.
12) Sher L. Role of selenium depletion in the effects of dialysis on mood and behavior. Medical Hypotheses
2002; 59(1): 89–9.
13)Soucie JM, McClellan WM. Early death in dialysis patients: risk factors and impact on incidence and mortality
rates. Journal of the American Society of Nephrology 1996;7(10):2169-75.
14) Cohen S, Kimmel PL. Nutritional status, psychological issues and survival in hemodialysis patients. Contrib
Nephrol 2007; 155:1-17.
15) Farrokhi F, Abedi N, Beyene J, Kurdyak P, Jassal SV. Association between depression and mortality in
patients receiving long-term dialysis: a systematic review and meta-analysis. Am J kidney Dis 2014; 63(4):623-
35.
16) Hawkes W C, Hornbostel L. Effects of dietary selenium on mood in healthy men living in a metabolic research
unit. Biol Psychiatry 1996; 39: 121–128.
17) Finley J. W., Penland J. G. Adequacy or deprivation of dietary selenium in healthy men: clinical and
psychological findings. J Trace Elem Exp Med 1998; 11: 11–27.
18) Benton D, Cook R. Selenium supplementation improves mood in a double-blind crossover trial. Biol
Psychiatry 1991; 29: 1092–1098.
19) Richard MJ, Ducros V, Foret M, Arnaud J, Coudray C,Fusselier M, et al. Reversal of selenium and zinc
deficiencies in chronic hemodialysis patients by intravenous sodium selenite and zinc gluconate supplementation.
Biol Trace Elem Res 1993; 39: 149–159.
20) Kimmel PL, Cukor D, Cohen SD, Peterson RA. Depression in end-stage renal disease patients: a critical
review. Adv Chronic kidney Dis 2007; 14(4):328-34.
21) Bonomini M, Forster S, De Risio F, Rychly J, Nebe B , Manfrini V, et al. Effects of selenium
supplementation on immune parameters in chronic uremic patients on hemodialysis. Nephrol Dial Transplant
1995; 10:1654–1661.
22) Fujishima Y, Ohsawa M, Itai K, Kato K, Tanno K, Chowdhury Turin T, et al. Serum selenium levels are
inversely associated with death risk among hemodialysis patients. Nephrol Dial Transplant 2011; 26: 3331–3338.
23) Rucker D, Thadhani R, Tonelli M. Trace element status in hemodialysis patients. Semin Dial 2010; 23: 389–
395.
24) Xia Y, Hill KE, Byrne DW, Xu J, Burk RF. Effectiveness of selenium supplements in a low-selenium area
of China, Am J Clin Nutr 2005; 81:829–834.
25) Xia Y, Hill KE, Li P, Xu J, Zhou D, Motley AK, et al. Optimization of selenoprotein P and other plasma
selenium biomarkers for the assessment of the selenium nutritional requirement: a placebo-controlled, doubleblind study of selenomethionine supplementation in selenium-deficient Chinese subjects, Am J Clin Nutr 2010;
92: 525–531.
26) Stockler-Pinto MB, Malm O ,Geraldo Azeved SR , Farag NE, Renato Dorneles P , Franciscato Cozzolino
SM ,et al. Selenium plasma levels in hemodialysis patients: comparison between North and Southeast of
Brazil. Bras Nefrol 2014; 36(4):490-5.
27) Beligaswatta C, Sudusinghe D, De Silva S, Davenport A. Prevalence and correlates of low plasma selenium
concentrations in peritoneal dialysis patients. Journal of Trace Elements in Medicine and Biology 2022; 69:
126899.
28) Ortaç E , Ozkaya O, Saraymen R, Yildi N , Bedir A , Buyan N , et al .Low hair selenium and plasma
glutathione peroxidase in children with chronic renal failure.Pediatr Nephrol 2006; 21(11):1739-45.
29) Esmaeili M, Rakhshanizadeh F. Serum trace elements in children with end-stage renal disease. J Ren Nutr
2019; 29(1):48-54.