Euthyroid Sick Syndrome and Nutritional Status are Correlated with Hyposelenemia in Hemodialysis Patients

Abstract

These data suggest that hyposelenemia in HD patients correlated with euthyroid sick syndrome with low T3 levels, and nutritional status with hyperlipidemia and hypoalbuminemia which might be involved in dysfunction in the endocrine and nutrition metabolism in dialysis patients.

Chronic Kidney Disease Distinctly Affects Relationship Between Selenoprotein P Status and Serum Thyroid Hormone Parameters

“…Moreover, low T3 concentrations as well as elevated TSH concentrations were also associated with a high mortality rate (2,36). In contrast to Liu et al, who found a positive correlation of serum Se and T3 and fT3 in their CHD patients, a correlation was not observed between SePP and TH parameters in the present dialysis group (32).…”

“…Here, SePP concentrations were significantly lower in the dialysis group. Low serum Se concentrations in dialysis patients were previously reported in several studies (6,8,31,32); this observation might be explained by a lower Se (via lower protein) intake and/or impaired intestinal absorption in sick dialysis patients and less likely by a loss of Se through the dialysis membrane (33). However, at present, it cannot be excluded that the dialysis membrane has specifically removed some of the circulating SePP, as this possibility has been suggested in patients undergoing low-density lipoprotein apheresis (34).…”

Selenium supplementation improves the nutritional status of hemodialysis patients: a randomized, double-blind, placebo-controlled trial

“…Furthermore, low levels of selenium in HD patients have been reported to be associated with increased inflammatory markers [27]. There are also reports on a possible association of selenium deficiency with increased risk of malnutrition in HD patients evidenced by significant positive correlations found between low levels of selenium and of nutritional markers such as serum albumin, total muscle mass, triceps skin-fold and mid-arm muscle circumference [11,14,15,26,28]. Although few interventional studies have demonstrated the beneficial effects of selenium supplementation on reducing oxidative stress markers or increasing the activity of antioxidant enzymes in HD patients [28][29][30][31][32], the potential efficacy of selenium supplementation in improving clinical outcomes like malnutrition in these patients has not been evaluated in any randomized controlled trial so far.…”

“…Several studies have demonstrated that HD patients have low levels of selenium compared with healthy controls, and deficiency of this trace element may contribute to increased oxidative stress and inflammation in HD patients [10][11][12][13]. Furthermore, strong positive correlations between levels of selenium and nutritional markers such as serum albumin have been reported [14,15]. Therefore, selenium deficiency may also contribute to malnutrition in HD patients [11].…”

Low triiodothyronine: A new facet of inflammation in acute ischemic stroke

“…It is an adaptive compensatory and therefore beneficial response aimed at maintaining energy balance and minimizing protein wasting in diseased states [5]. However, altered thyroid hormone metabolism, characterized by low circulating T3 levels, has been described in patients with cardiovascular disease, pulmonary disorders, chronic kidney disease and brain tumor [6,7,8,9], suggested that this alteration is less benign than previously thought [10]. And recent studies showed that low-T3 during the acute phase of AIS may be a predictor of poor clinical and functional outcomes [11,12].…”