Reversal of selenium and zinc deficiencies in chronic hemodialysis patients by intravenous sodium selenite and zinc gluconate supplementation

Abstract

In six chronic dialyzed uremic patients, an intravenous sodium selenite (Se 50 micrograms during 5 wk and then 100 micrograms) and zinc gluconate (Zn 5 mg) supplementation was performed during 20 wk at each dialysis session three times weekly. Before supplementation, plasma Se and Zn, plasma and erythrocytes (RBC) antioxidant metallo-enzymes glutathione peroxidase (GPX), and superoxide dismutase (SOD) were significantly decreased, whereas lipid peroxidation (as thiobarbituric acid reactants TBARs) was increased. To obtain a significative change in plasma selenium, we had to use an Se dose of 100 micrograms/dialysis session. Then, treatment-increased plasma Se (from 0.58 +/- 0.09 to 0.89 +/- 0.16 mumol/L) led to a repletion of RBC-GPX (from 29.6 +/- 6 to 43 +/- 5.8 U/g Hb) and increased plasma GPX levels (from 62 +/- 13 to 151 +/- 43 U/L). Plasma Zn and RBC-SOD did not vary significantly. The change of TBARs was not observed between wk 1 and 4. They decreased significantly between wk 4 (4.80 +/- 0.21 mumol/L) and wk 20 (4.16 +/- 0.26 mumol/L). We noted a low correlation between TBARs and plasma GPX. A strong correlation was observed between Se and plasma GPX. The reversal of Se deficiencies should reduce oxidative damage observed in these patients.

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

“…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.…”

Selenium (Se), Blood Glutathione Peroxidases and DNA Damage in Chronic Kidney Disease Patients on Hemodialysis and After Kidney Transplantation - The Effect of Se Supplementation

“…Studies of the effects of Se supply on plasma GSH-Px activity in patients on HD, carried out by various authors, have produced ambiguous results. Some authors show statistically significant increase in this enzyme activity after Se supplementation to dialyzed patients (Richard et al, 1991;Richard et al, 1993;Bellisola et al, 1994), others have shown slightly raised activity at the end of the HD session (Schiavon et. al., 1994a) or did not report any substantial differences (Zachara et al, 1994(Zachara et al, , 2001).…”

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

“…Mindez az oxidatív stresszhatások növekedésé-hez vezet, megnövelve a lipidperoxidációt, az anaemia mértékét, és szerepet játszhat az atherosclerosis progressziójában a hemodialízis során [26,39,40,41,42]. A plazma és a vörösvértest szelénkoncentrációja korrelál a GSHP-aktivitással és a dialíziskezelés időtartamá-val [33,43]. Nem dializált krónikus vesebetegekben nem csökken a vörösvértestekben a GSHP-aktivitás [36], de mind a szérumszelén-koncentráció, mind a plazmaés vörösvértest-GSHP-aktivitás megnő szelénszupple-mentációt követően [24,44].…”

“…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]. Vesebetegekben az orális vagy intravénás szelénadagolás csökken-tette az oxidatív stressz káros hatásait.…”