Altered Serum Selenium and Uric Acid Levels and Dyslipidemia in Hemodialysis Patients Could be Associated with Enhanced Cardiovascular Risk

Moral, Loreto Martí del; Agil, Ahmad; Navarro-Alarcón, Miguel; Serrana, Herminia López-Ga de la; Palomares-Bayo, Magdalena; Oliveras‐López, María‐Jesús

doi:10.1007/s12011-011-9152-4

Cited by 31 publications

(19 citation statements)

References 33 publications

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“…In a 6-month longitudinal study with three 3-month repeated blood samplings, no statistically significant differences among the UA levels were found in 48 patients on HD (24). However, in agreement to our findings, in a 2-year study, on the basis of four 6-month blood samples, UA significantly decreased over the study period in 117 patients on HD (25). With regard to nutritional status, most of studies have shown that MHD associates with a significant decline in certain laboratory nutritional parameters, including albumin (26,27), as well as anthropometric measurements (27,28).…”

Section: Discussionsupporting

confidence: 87%

Longitudinal Study of Serum Uric Acid, Nutritional Status, and Mortality in Maintenance Hemodialysis Patients

Beberashvili

Erlich²,

Azar

et al. 2016

CJASN

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Background and objectives We hypothesized that longitudinal changes in uric acid (UA) may have independent associations with changes in nutritional parameters over time and consequently, long-term survival of patients on maintenance hemodialysis.Design, setting, participants, & measurements We conducted a retrospective, longitudinal cohort study of a clinical database containing the medical records of patients on maintenance hemodialysis receiving dialysis between June of 1999 and December of 2012 in a single center; 200 patients (130 men and 70 women) with a median age of 69.0 (interquartile range, 59.3-77.0) years old were included in the study. Dietary intake, biochemical markers of nutrition, anthropometric measurements, and UA levels were recorded at 0, 6, 12, 18, 24, 30, and 36 months followed by 15 additional months of clinical observations. The patients were followed until January 31, 2015 (median follow-up was 38.0 [interquartile range, 30.0-46.8] months).Results In a linear mixed effects model adjusted for baseline demographics and clinical parameters, each 1.0-mg/dl longitudinal increase in UA was associated with a 13.4% slower rate of decline in geriatric nutritional risk index (GNRI) levels over 3 years of observation (95% confidence interval [95% CI], 0.11 to 0.39; P,0.001 for UA 3 time interaction). UA remained associated with the rate of change in GNRI, even after controlling for C-reactive protein. During the follow-up, 87 (43.5%) all-cause and 38 (19.0%) cardiovascular deaths were reported. For each 1.0-mg/dl increase in serum UA over time, the multivariate adjusted all-cause mortality hazard ratio using Cox models with the effect of time-varying risk was 0.83 (95% CI, 0.74 to 0.95; P,0.01), which continued to be significant, even after including the baseline GNRI levels in this model: 0.89 (95% CI, 0.79 to 0.98; P=0.02).Conclusions Longitudinal changes in serum UA seem to track with changes in nutritional status over time, and these changes are associated with survival of patients on maintenance hemodialysis. An increase in serum UA levels over time is accompanied by improvement of nutritional status and lower mortality rate.

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Section: Discussionsupporting

confidence: 87%

Longitudinal Study of Serum Uric Acid, Nutritional Status, and Mortality in Maintenance Hemodialysis Patients

Beberashvili

Erlich²,

Azar

et al. 2016

CJASN

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“…Similarly to other diseases, a decreased Se level may be a direct or indirect consequence of renal failure, but could also exacerbate the oxidative damage, enhancing the susceptibility to complications occurring in CVD. 178 …”

Section: Renal Failurementioning

confidence: 99%

Selenium biochemistry and its role for human health

Roman¹,

Jitaru²,

Barbante³

2014

Metallomics

629

451

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Despite its very low level in humans, selenium plays an important and unique role among the (semi)metal trace essential elements because it is the only one for which incorporation into proteins is genetically encoded, as the constitutive part of the 21st amino acid, selenocysteine. Twenty-five selenoproteins have been identified so far in the human proteome. The biological functions of some of them are still unknown, whereas for others there is evidence for a role in antioxidant defence, redox state regulation and a wide variety of specific metabolic pathways. In relation to these functions, the selenoproteins emerged in recent years as possible biomarkers of several diseases such as diabetes and several forms of cancer. Comprehension of the selenium biochemical pathways under normal physiological conditions is therefore an important requisite to elucidate its preventing/therapeutic effect for human diseases. This review summarizes the most recent findings on the biochemistry of active selenium species in humans, and addresses the latest evidence on the link between selenium intake, selenoproteins functionality and beneficial health effects. Primary emphasis is given to the interpretation of biochemical mechanisms rather than epidemiological/observational data. In this context, the review includes the following sections: (1) brief introduction; (2) general nutritional aspects of selenium; (3) global view of selenium metabolic routes; (4) detailed characterization of all human selenoproteins; (5) detailed discussion of the relation between selenoproteins and a variety of human diseases.

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“…Hemodializált betegekben az antioxidáns hatású húgysavat is gyulladásos biomarkerként tartják számon. Krónikus vesebetegségben és veseelégtelenségben a betegségprogresszióval arányosan hyperurikaemia és szelénhiány alakul ki, amelyek egymással korrelálnak és fokozzák a cardiovascularis kockázatot [81]. A szelénpótlás hatásos lehet az oxidatív stressz csökkentésére [24,43,82,83,84].…”

Section: Szelénhiány éS Mortalitásunclassified

Importance of selenium homeostasis in chronic and end-stage kidney diseases

Kiss

2013

Orvosi Hetilap

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A szelén az emberi szervezet számára nélkülözhetetlen nyomelem, jelentős antioxidáns hatással rendelkezik. A szelénhiány és -többlet egyaránt károsan befolyásolja a szervezet működését. A szelénhiány és az akut vagy krónikus vesebetegség, illetve a szövődmények kapcsolata kevésbé intenzíven kutatott terület. Az eddigi eredmények alapján ismertté vált, hogy a szelénhiány és a veseelégtelenség fokozza a koszorúér-betegség okozta és az összhalálozás kockázatát. További megfi gyelések szerint a szelénhiány az immunrendszer működési zavarán keresztül fokozza az infekció okozta halálozás kockázatát hemodializált betegekben. Jelenleg azonban nincs tudomásunk arról, hogy a szelén-háztartás zavara, elsősorban a szelén hiánya, krónikus vesebetegséget vagy veseelégtelenséget okozna. Ugyanakkor elégséges ismerettel rendelkezünk arról, hogy a fehérjevesztés és a vesepótló kezelés csökkentheti a szelénszintet. A szelénhiány és a krónikus vesebetegség kapcsolatával foglalkozó vizsgálatok gyakran ellentmondó eredményei ellenére úgy tűnik, hogy súlyos vagy végállapotú, vesepótló kezelésre szoruló dializált betegekben a szelénszupplemen-táció számos esetben kedvező lehet. Orv. Hetil., 2013, 154, 1641-1647. Kulcsszavak: szelénhiány, cardiovascularis kockázat, krónikus vesebetegség, vesepótló kezelés Importance of selenium homeostasis in chronic and end-stage kidney diseasesSelenium is an essential trace element for the human body with a signifi cant antioxidant effect. Selenium defi ciency and excess are both detrimental for proper functioning of the human body. The possible association between selenium defi ciency and acute or chronic renal disease, along with their complications has been less intensively investigated, however, there are fi rm data showing that selenium defi ciency and renal failure increase the risk of both coronary artery disease and total mortality. Further studies revealed that selenium defi ciency increases the risk of death due to infection in patients treated with hemodialysis through dysfunction of the immune system. However, there are no data whether the imbalance of selenium metabolism, especially selenium defi ciency, could cause chronic kidney disease or renal failure. As far as results of selenium measurements, there is convincing evidence that protein loss and renal replacement treatment reduce serum selenium levels. Despite some contradictory results obtained from various studies regarding selenium defi ciency in chronic kidney diseases, it seems that selenium supplementation may be benefi cial in many patients with severe or end-stage kidney disease including those treated with dialysis.Keywords: selenium defi ciency, cardiovascular risk, chronic renal disease, hemodialysis Kiss, I. (2013)

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Altered Serum Selenium and Uric Acid Levels and Dyslipidemia in Hemodialysis Patients Could be Associated with Enhanced Cardiovascular Risk

Cited by 31 publications

References 33 publications

Longitudinal Study of Serum Uric Acid, Nutritional Status, and Mortality in Maintenance Hemodialysis Patients

Longitudinal Study of Serum Uric Acid, Nutritional Status, and Mortality in Maintenance Hemodialysis Patients

Selenium biochemistry and its role for human health

Importance of selenium homeostasis in chronic and end-stage kidney diseases

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