Abstract
In the present study, the first objective was to follow up serum selenium (Se) concentrations in 117 hemodialysis patients (HPs) during a 2-year longitudinal study, relating concentrations to biochemical indexes (n = 6; namely lipoprotein profile, uric acid, and total protein levels). It was also evaluated whether the disease is associated with an enhanced cardiovascular risk. A healthy control group (n = 50) was also studied. Mean serum Se levels were significantly lower in HPs than in the controls (p = 0.002); mean levels significantly increased from the first to third blood sampling (p < 0.001). HPs showed a marked dyslipidemia, with a significant reduction in total cholesterol, low-density lipoprotein, and high-density lipoprotein cholesterol levels and a significant increase in triglyceride levels (p < 0.001). HPs showed a marked hyperuricemia (p < 0.001). Serum selenium levels in HPs were correlated negatively with uric acid levels (inflammation biomarker; p < 0.01). In HPs, serum Se levels are reduced due to their disease (chronic renal failure). Serum Se levels rose until the third blood sampling. The marked dyslipidemia and hyperuricemia found in HPs and the negative correlation between the serum Se and uric acid levels in these patients could imply an enhanced cardiovascular risk.
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Berger MM, Shenkin A, Revelly JP et al (2004) Copper, selenium, zinc and thiamine balances during continuous venovenous hemodiafiltration in critically ill patients. Am J Clin Nutr 80:410–416
Borawska MH, Witkowska AM, Hutalowicz K et al (2007) Influence of dietary habits on serum selenium concentration. Ann Nutr Metabol 48:34–40
Zachara BA, Gromadzinska J, Wasowicz W et al (2006) Red blood cell in plasma glutathione peroxidase activities and selenium concentration in patients with chronic kidney disease: a review. Acta Biochim Pol 53:663–677
Taccone-Gallucci M, Noce A, Bertucci P et al (2010) Chronic treatment with statins increases the availability of selenium in the antioxidant defence systems of hemodialysis patients. J Trace Elem Medic Biol 24:27–30
Bober J, Kwiatkowska E, Kedzierska K et al (2007) Influence of glucose in the dialysate on the activity of erythrocyte-glutathione-peroxidase and blood selenium concentration in hemodialyzed patients. Arch Med Res 38:330–336
Torra M, Casals G, Cervera C et al (2007) Selenium status in healthy subjects and patients with different stages of chronic renal failure living in Barcelona, Northeast Spain. Trace Elem Electrol 24:92–96
Ortac E, Ozkaya O, Saraymen R et al (2006) Low hair selenium and plasma glutathione peroxidase in children with chronic renal failure. Pediatr Nephrol 21:1739–1745
Andrew NH, Engel B, Hart K et al (2008) Micronutrient intake in haemodialysis patients. J Hum Nutr Diet 21:375–378
Fang YZ, Yang S, Wu G (2002) Free radicals, antioxidants, and nutrition. Nutrition 18:872–879
Alimonda AL, Núñez J, Nuñez E et al (2009) Hyperuricemia in acute heart failure. More than a simple spectator? Eur J Int Med 20:74–79
Leyva F, Anker S, Swan JW et al (1997) Serum uric acid as an index of impaired oxidative metabolism in chronic heart failure. Eur Heart J 18:858–865
Leyva F, Anker SD, Godsland IF et al (1998) Uric acid in chronic heart failure: a marker of chronic inflammation. Eur Heart J 19:1814–1822
Hoeper MM, Hohfeld JM, Fabel H (1999) Hyperuricaemia in patients with right or left heart failure. Eur Respir J 13:682–685
Culleton BF, Larson MG, Kannel WB et al (1999) Serum uric acid and risk for cardiovascular disease and death: the Framinghan Heart Study. Ann Intern Med 131:7–13
Niskanen LK, Laaksonen DE, Nyyssonen K et al (2004) Uric acid level as a risk factor for cardiovascular and all-cause mortality in middle-aged men: a prospective cohort study. Arch Intern Med 164:1546–1551
Yeum KJ, Beretta G, Krinsky NI et al (2009) Synergistic interactions of antioxidant nutrients in a biological model system. Nutrition 25:839–846
Szeto YT, Timothy CY, Kowk TCY et al (2004) Effects of a long-term vegetarian diet on biomarkers of antioxidant status and cardiovascular disease risk. Nutrition 20:863–866
Castilla P, Echarri R, Dávalos A et al (2006) Concentrated red grape juice exerts antioxidant, hypolipidemic, and antiinflammatory effects in both hemodialysis patients and healthy subjects. Am J Clin Nutr 84:252–262
Jackson P, Lougherey CM, Lightbody JH et al (1995) Effect of hemodialysis on total antioxidant capacity and serum antioxidants in patients with chronic renal failure. Clin Chem 41:1135–1138
Navarro-Alarcón M, López-Gª de la Serrana H, Pérez-Valero V et al (1999) Serum and urine selenium concentrations in patients with cardiovascular diseases and relationship to other nutritional and biochemical indexes. Ann Nutr Metab 43:30–36
Navarro-Alarcon M, López-Gª de la Serrana H, Pérez-Valero V et al (2002) Selenium concentration in serum of individuals with liver diseases (cirrhosis or hepatitis): relationship with some nutritional and biochemical markers. Sci Total Environ 291:135–141
Martínez-Peinado M, Nogueras-López F, Arcos-Cebrián A et al (2010) Serum selenium levels in cirrhotic patients are not influenced by the disease severity index. Nutr Res 30:574–578
Hesieh YY, Shen WS, Lee LY et al (2006) Long-term changes in trace elements in patients undergoing chronic hemodialysis. Biol Trace Elem Res 109:115–121
Yilmaz MI, Saglam M, Caglar K et al (2006) Pathogenesis and treatment of kidney disease and hypertension—the determinants of endothelial dysfunction in CKD: oxidative stress and asymmetric dimethylarginine. Am J Kidney Dis 47:42–50
Chen B, Lamberts LV, Behets GH et al (2009) Selenium, lead, and cadmium levels in renal failure patients in China. Biol Trace Elem Res 131:1–12
Pakfetrat M, Malekmakan L, Hasheminasab M (2010) Diminished selenium levels in hemodialysis and continuous ambulatory peritoneal dialysis patients. Biol Trace Elem Res 137:335–339
Fujishima Y, Ohsawa M, Itai K et al (2011) Serum selenium levels in hemodialysis patients are significantly lower than those in healthy controls. Blood Purific 32:43–47
Salgueiro MJ, Bocio JR (2001) Nutritional care in renal disease patients. Nutrition 17:157
Zagrodzki P, Barton H, Walas S et al (2007) Selenium status indices, laboratory data, and selected biochemical parameters in end-stage renal disease patients. Biol Trace Elem Res 116:29–41
Martins C (2004) Vitaminas y oligoelementos en la insuficiencia renal. In: Riella MC, Martins C (eds) Nutrición y riñón. Editorial Médica Panamericana, Madrid, pp 46–62
Zwolinska D, Grzeszczak W, Kilis-Pstrusinska K et al (2004) Lipid peroxidation and antioxidant enzymes in children with chronic renal failure. Pediatr Nephrol 19:888–892
Zachara BA, Wlodarczyk Z, Andruszkiewicz J et al (2005) Glutathione and glutathione peroxidase activities in blood of patients in early stages following kidney transplantation. Ren Fail 27:751–755
Navarro-Alarcón M, Cabrera-Vique C (2008) Selenium in food and human body: a review. Sci Total Environ 400:115–141
Sigolo Teixeira P, Riella MC (2004) Metabolismo de las proteínas, de los hidratos de carbono y de los lípidos en la insuficiencia renal. In: Riella MC, Martins C (eds) Nutrición y Riñón. Editorial Médica Panamericana, Madrid, pp 12–27
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The authors would like to thank all the volunteers for their participation. The study was supported by grant AGR-141 (Junta de Andalucía) Spain.
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Martí del Moral, L., Agil, A., Navarro-Alarcón, M. et al. Altered Serum Selenium and Uric Acid Levels and Dyslipidemia in Hemodialysis Patients Could be Associated with Enhanced Cardiovascular Risk. Biol Trace Elem Res 144, 496–503 (2011). https://doi.org/10.1007/s12011-011-9152-4
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DOI: https://doi.org/10.1007/s12011-011-9152-4