The Impact of Inflammatory Profile on Selenium Levels in Hemodialysis Patients

Author(s): Marcelo R. Bacci, Lívia S.S. Cabral, Glaucia L. da Veiga*, Beatriz da C.A. Alves, Neif Murad, Fernando L.A. Fonseca

Journal Name: Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry
Formerly Current Medicinal Chemistry - Anti-Inflammatory & Anti-Allergy Agents

Volume 19 , Issue 1 , 2020

Become EABM
Become Reviewer
Call for Editor


Introduction: Hemodialysis stands out as an eligible treatment for patients with chronic kidney disease. The subsequent inflammatory process resulting from this disease and hemodialysis per se is exacerbated in this therapy. Selenium (Se) is an essential trace element that can participate in the inhibition of pro-oxidant and pro-inflammatory processes and could be considered a measurement that indicates the progression of chronic kidney disease and inflammation.

Objectives: The present study investigated selenemia in hemodialysis patients of the ABC region of São Paulo and aimed to establish the correlation between an inflammatory marker and selenemia in this conditions disease.

Methods: This is an observational cross-sectional study of the Faculdade de Medicina do ABC in patients submitted to hemodialysis three times a week for at least six months. The eligible group composed of 21 patients, who filled out forms and underwent biochemical tests (colorimetric enzyme methods, flow cytometer, turbidimetric method and mass spectrometry).

Results: The study population showed, women (70%), men (30%) with a mean age of 47 ± 17 years, Caucasians (36%) and non-Caucasian (64%), hypertensive (68%), smokers (53%) and non-smokers (64%). There was a hegemonic prevalence of systolic arterial hypertension (SAH) 68.1% in relation to diabetes mellitus (DM) (50%). Pre and post hemodialysis (HD) selenemia showed statistical significance, which did not occur with Creactive protein. There was a predominance of females in our sample; the pre- and post- HD selenemia were within the normal range of the reference values; there was a statistically significant correlation between pre and post-HD selenemia; there was no correlation with statistical significance between values of pre and post-HD C-reactive protein.

Conclusion: Our data showed that there was no direct relationship between pre- and post- HD inflammation and pre- and post-HD selenemia.

Keywords: Chronic kidney disease, hemodialysis, selenium, pro-oxidant, inflammation, systemic arterial hypertension.

Barsoum, R.S. Chronic kidney disease in the developing world. N. Engl. J. Med., 2006, 354(10), 997-999.
[] [PMID: 16525136]
Haroun, M.K.; Jaar, B.G.; Hoffman, S.C.; Comstock, G.W.; Klag, M.J.; Coresh, J. Risk factors for chronic kidney disease: a prospective study of 23,534 men and women in Washington County, Maryland. J. Am. Soc. Nephrol., 2003, 14(11), 2934-2941.
[] [PMID: 14569104]
Kosmas, C.E.; Silverio, D.; Tsomidou, C.; Salcedo, M.D.; Montan, P.D.; Guzman, E. The impact of insulin resistance and chronic kidney disease on inflammation and cardiovascular disease. Clin. Med. Insights Endocrinol. Diabetes, 2018, 11 1179551418792257
Vanholder, R.; Van Laecke, S.; Glorieux, G.; Verbeke, F.; Castillo-Rodriguez, E.; Ortiz, A. Deleting death and dialysis: Conservative care of cardio-vascular risk and kidney function loss in Chronic Kidney Disease (CKD). Toxins (Basel), 2018, 10(6)E237
[] [PMID: 29895722]
Mann, J.F.; Gerstein, H.C.; Pogue, J.; Bosch, J.; Yusuf, S. Renal insufficiency as a predictor of cardiovascular outcomes and the impact of ramipril: the HOPE randomized trial. Ann. Intern. Med., 2001, 134(8), 629-636.
[] [PMID: 11304102]
Greco, F.; Fornara, P.; Mirone, V. Renal transplantation: technical aspects, diagnosis and management of early and late urological complications. Panminerva Med., 2014, 56(1), 17-29.
[PMID: 24637470]
de Zeeuw, D.; Hillege, H.L.; de Jong, P.E. The kidney, a cardiovascular risk marker, and a new target for therapy. Kidney Int. Suppl., 2005, 98(98), S25-S29.
[] [PMID: 16108967]
Mastroianni-Kirsztajn, G.; Bastos, M.G.; Burdmann, E.A. Strategies of the Brazilian chronic kidney disease prevention campaign (2003-2009). Nephron Clin. Pract., 2011, 117(3), c259-c265.
[] [PMID: 20861650]
Collins, A.J.; Foley, R.N.; Chavers, B.; Gilbertson, D.; Herzog, Z.; Johansen, K. US renal data system 2011 annual data report. Am. J. Kidney Dis., 2012, 59, e1-e420.
Sesso, R.C.; Lopes, A.A.; Thomé, F.S.; Lugon, J.R.; Martins, C.T. Brazilian chronic dialysis census 2014. J. Bras. Nefrol., 2016, 38(1), 54-61.
[] [PMID: 27049365]
Keith, D.S.; Nichols, G.A.; Gullion, C.M.; Brown, J.B.; Smith, D.H. Longitudinal follow-up and outcomes among a population with chronic kidney disease in a large managed care organization. Arch. Intern. Med., 2004, 164(6), 659-663.
[] [PMID: 15037495]
Suliman, M.E.; Stenvinkel, P. Contribution of inflammation to vascular disease in chronic kidney disease patients. Saudi J. Kidney Dis. Transpl., 2008, 19(3), 329-345.
[PMID: 18445891]
Stenvinkel, P.; Ketteler, M.; Johnson, R.J.; Lindholm, B.; Pecoits-Filho, R.; Riella, M.; Heimbürger, O.; Cederholm, T.; Girndt, M. IL-10, IL-6, and TNF-alpha: central factors in the altered cytokine network of uremia--the good, the bad, and the ugly. Kidney Int., 2005, 67(4), 1216-1233.
[] [PMID: 15780075]
Oberg, B.P.; McMenamin, E.; Lucas, F.L.; McMonagle, E.; Morrow, J.; Ikizler, T.A.; Himmelfarb, J. Increased prevalence of oxidant stress and inflammation in patients with moderate to severe chronic kidney disease. Kidney Int., 2004, 65(3), 1009-1016.
[] [PMID: 14871421]
Donderski, R.; Stróżecki, P.; Sulikowska, B.; Grajewska, M.; Miśkowiec, I.; Stefańska, A.; Siódmiak, J.; Odrowąż-Sypniewska, G.; Manitius, J. Aldosterone antagonist therapy and its relationship with inflammation, fibrosis, thrombosis, mineral-bone disorder and cardiovascular complications in peritoneal dialysis (PD) patients. Int. Urol. Nephrol., 2017, 49(10), 1867-1873.
[] [PMID: 28710615]
Steinbrenner, H.; Speckmann, B.; Sies, H. Toward understanding success and failures in the use of selenium for cancer prevention. Antioxid. Redox Signal., 2013, 19(2), 181-191.
[] [PMID: 23421468]
Čobanová, K.; Faix, Š.; Plachá, I.; Mihaliková, K.; Váradyová, Z.; Kišidayová, S.; Grešáková, Ľ. Effects of different dietary selenium sources on antioxidant status and blood phagocytic activity in sheep. Biol. Trace Elem. Res., 2017, 175(2), 339-346.
[] [PMID: 27411926]
Valea, A.; Georgescu, C.E. Selenoproteins in human body: focus on thyroid pathophysiology. Hormones (Athens), 2018, 5
Combs, G.F. Biomarkers of selenium status. Nutrients, 2015, 7(4), 2209-2236.
[] [PMID: 25835046]
Stockler-Pinto, M.B.; Lobo, J.; Moraes, C.; Leal, V.O.; Farage, N.E.; Rocha, A.V.; Boaventura, G.T.; Cozzolino, S.M.; Malm, O.; Mafra, D. Effect of Brazil nut supplementation on plasma levels of selenium in hemodialysis patients: 12 months of follow-up. J. Ren. Nutr., 2012, 22(4), 434-439.
[] [PMID: 22217537]
Stockler-Pinto, M.B.; Malm, O.; Azevedo, S.R.; Farage, N.E.; Dorneles, P.R.; Cozzolino, S.M.; Mafra, D. Selenium plasma levels in hemodialysis patients: comparison between North and Southeast of Brazil. J. Bras. Nefrol., 2014, 36(4), 490-495.
[] [PMID: 25517278]
Sesso, R.C. Diálise crônica no Brasil - relatório do censo bra-sileiro de diálise. 2011. J. Bras. Nefrol., 2012, 34(3), 272-277.
Sanz Alaejos, M.; Díaz Romero, C. Urinary selenium concentrations. Clin. Chem., 1993, 39(10), 2040-2052.
[] [PMID: 8403389]
Zachara, B.A.; Gromadzińska, J.; Wasowicz, W.; Zbróg, Z. Red blood cell and plasma glutathione peroxidase activities and selenium concentration in patients with chronic kidney disease: a review. Acta Biochim. Pol., 2006, 53(4), 663-677.
[] [PMID: 17160142]
Wołonciej, M.; Milewska, E.; Roszkowska-Jakimiec, W. Trace elements as an activator of antioxidant enzymes. Postepy Hig. Med. Dosw., 2016, 70, 1483-1498.
[] [PMID: 28100855]
Thomson, C.D. Assessment of requirements for selenium and adequacy of selenium status: a review. Eur. J. Nutr., 2004. 58391402
Fujishima, Y.; Ohsawa, M.; Itai, K.; Kato, K.; Tanno, K.; Turin, T.C.; Onoda, T.; Endo, S.; Okayama, A.; Fujioka, T. Serum selenium levels are inversely associated with death risk among hemodialysis patients. Nephrol. Dial. Transplant., 2011, 26(10), 3331-3338.
[] [PMID: 21372251]
Gómez de Oña, C.; Martínez-Morillo, E.; Gago González, E.; Vidau Argüelles, P.; Fernández Merayo, C.; Álvarez Menéndez, F.V. Variation of trace element concentrations in patients undergoing hemodialysis in the north of Spain. Scand. J. Clin. Lab. Invest., 2016, 76(6), 492-499.
[] [PMID: 27362816]
Rayman, M.P. Selenium and human health. Lancet, 2012, 379(9822), 1256-1268.
[] [PMID: 22381456]
Foley, R.N.; Sexton, D.J.; Drawz, P.; Ishani, A.; Reule, S. Race, ethnicity, and end-of-life care in dialysis patients in the United States. J. Am. Soc. Nephrol., 2018, 29(9), 2387-2399.
[] [PMID: 30093455]
Stack, A.G.; Bloembergen, W.E. Prevalence and clinical correlates of coronary artery disease among new dialysis patients in the United States: a cross-sectional study. J. Am. Soc. Nephrol., 2001, 12(7), 1516-1523.
[PMID: 11423581]
Sarnak, M.J.; Coronado, B.E.; Greene, T.; Wang, S.R.; Kusek, J.W.; Beck, G.J.; Levey, A.S. Cardiovascular disease risk factors in chronic renal insufficiency. Clin. Nephrol., 2002, 57(5), 327-335.
[] [PMID: 12036190]
Ohsawa, M.; Kato, K.; Itai, K.; Onoda, T.; Konda, R.; Fujioka, T.; Nakamura, M.; Okayama, A. KAREN Study Group. Cardiovascular risk factors in hemodialysis patients: results from baseline data of kaleidoscopic approaches to patients with end-stage renal disease study. J. Epidemiol., 2005, 15(3), 96-105.
[] [PMID: 15930806]
Portolés, J.; López-Gómez, J.M.; Aljama, P. Cardiovascular risk in hemodialysis in Spain: prevalence, management and target results (MAR study). Nefrologia, 2005, 25(3), 297-306.
[PMID: 16053011]
Agarwal, R.; Nissenson, A.R.; Batlle, D.; Coyne, D.W.; Trout, J.R.; Warnock, D.G. Prevalence, treatment, and control of hypertension in chronic hemodialysis patients in the United States. Am. J. Med., 2003, 115(4), 291-297.
[] [PMID: 12967694]
Heerspink, H.J.; Ninomiya, T.; Zoungas, S.; de Zeeuw, D.; Grobbee, D.E.; Jardine, M.J.; Gallagher, M.; Roberts, M.A.; Cass, A.; Neal, B.; Perkovic, V. Effect of lowering blood pressure on cardiovascular events and mortality in patients on dialysis: a systematic review and meta-analysis of randomised controlled trials. Lancet, 2009, 373(9668), 1009-1015.
[] [PMID: 19249092]
Agarwal, R.; Sinha, A.D. Cardiovascular protection with antihypertensive drugs in dialysis patients: systematic review and meta-analysis. Hypertension, 2009, 53(5), 860-866.
[] [PMID: 19273737]
The National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. United States Renal Data System. Excerpts from USRDS 2009 Annual Data Report. U.S. Department of Health and Human Services Am. J. Kidney Dis, 2010, 55(Suppl 1), S1NS420.
Pérez-García, R.; Martín-Malo, A.; Fort, J.; Cuevas, X.; Lladós, F.; Lozano, J.; García, F. ANSWER study. Baseline characteristics of an incident haemodialysis population in Spain: results from ANSWER--a multicentre, prospective, observational cohort study. Nephrol. Dial. Transplant., 2009, 24(2), 578-588.
[] [PMID: 19028750]
Longenecker, J.C.; Coresh, J.; Powe, N.R.; Levey, A.S.; Fink, N.E.; Martin, A.; Klag, M.J. Traditional cardiovascular disease risk factors in dialysis patients compared with the general population: the CHOICE Study. J. Am. Soc. Nephrol., 2002, 13(7), 1918-1927.
Tonelli, M.; Wiebe, N.; Hemmelgarn, B.; Klarenbach, S.; Field, C.; Manns, B.; Thadhani, R.; Gill, J. Alberta kidney disease network. Trace elements in hemodialysis patients: a systematic review and meta-analysis. BMC Med., 2009, 7, 25.
[] [PMID: 19454005]
Prabhu, K.S.; Zamamiri-Davis, F.; Stewart, J.B.; Thompson, J.T.; Sordillo, L.M.; Reddy, C.C. Selenium deficiency increases the expression of inducible nitric oxide synthase in RAW 264.7 macrophages: role of nuclear factor-kappaB in up-regulation. Biochem. J., 2002, 366(Pt 1), 203-209.
[] [PMID: 12006087]
Yavuz, O.; Bicik, Z.; Cinar, Y.; Guney, Y.; Guler, S. The effect of different dialysis membranes on oxidative stress and selenium status. Clin. Chim. Acta, 2004, 346(2), 153-160.
[] [PMID: 15256316]
Bonomini, M.; Forster, S.; De Risio, F.; Rychly, J.; Nebe, B.; Manfrini, V.; Klinkmann, H.; Albertazzi, A. Effects of selenium supplementation on immune parameters in chronic uraemic patients on haemodialysis. Nephrol. Dial. Transplant., 1995, 10(9), 1654-1661.
[ ] [PMID: 8559485]
Persson-Moschos, M.E.; Stavenow, L.; Akesson, B.; Lindgärde, F. Selenoprotein P in plasma in relation to cancer morbidity in middle-aged Swedish men. Nutr. Cancer, 2000, 36(1), 19-26.
[] [PMID: 10798212]
Flores-Mateo, G.; Navas-Acien, A.; Pastor-Barriuso, R.; Guallar, E. Selenium and coronary heart disease: a meta-analysis. Am. J. Clin. Nutr., 2006, 84(4), 762-773.
[] [PMID: 17023702]
Dworkin, B.; Weseley, S.; Rosenthal, W.S.; Schwartz, E.M.; Weiss, L. Diminished blood selenium levels in renal failure patients on dialysis: correlations with nutritional status. Am. J. Med. Sci., 1987, 293(1), 6-12.
[] [PMID: 3812549]
Liu, M.L.; Xu, G.; Huang, Z.Y.; Zhong, X.C.; Liu, S.H.; Jiang, T.Y. Euthyroid sick syndrome and nutritional status are correlated with hyposelenemia in hemodialysis patients. Int. J. Artif. Organs, 2011, 34(7), 577-583.
[] [PMID: 21786251]

open access plus

Rights & PermissionsPrintExport Cite as

Article Details

Year: 2020
Published on: 21 January, 2019
Page: [42 - 49]
Pages: 8
DOI: 10.2174/1871523018666190121165902

Article Metrics

PDF: 27
PRC: 1