Selenium supplementation to chronic kidney disease patients on hemodialysis does not induce the synthesis of plasma glutathione peroxidase.

Abstract

Numerous authors have shown that selenium (Se) concentration and glutathione peroxidase (GSH-Px) activity in plasma of chronic kidney disease (CKD) patients are lower than in healthy subjects, but there are only few publications on the level of GSH-Px protein in those patients and no reports on the effect of Se supplementation to HD patients on the level of this enzyme. Se concentration and GSH-Px protein level in plasma were measured in a group of 30 CKD patients on hemodialysis (HD) supplemented with 200 microg Se/day for 3 months, and 28 patients on HD administered with placebo. Se concentration was measured by graphite furnace atomic absorption spectrometry and plasma GSH-Px protein level by the sandwich ELISA method using polyclonal antibody specific for human plasma GSH-Px. Se concentration in patients on placebo did not change throughout the 3-month study period, but increased significantly in Se supplemented group. Se supplementation to CKD patients on HD had no effect on the level of GSH-Px protein. The lack of GSH-Px protein in CKD patients on HD is not linked to Se deficiency since the level of this element increased after Se supplementation while enzyme protein level did not change. The damaged kidney of HD patients is unable to synthesize GSH-Px, even after induction with selenium.

Efficacy of Nutritional Interventions on Inflammatory Markers in Haemodialysis Patients: A Systematic Review and Limited Meta-Analysis

“…Supplementation with Se-enriched yeast increases plasma Se concentrations in HD patients, but plasma GSH-Px concentrations were not impacted. The kidney is suggested as the main site for plasma GSH-Px synthesis, and low plasma GSH-Px levels in CKD patients therefore may not be related to Se deficiency but may rather be due to the failure of the kidneys to synthesize GSH-Px [ 100 , 101 ]. Therefore, the potential beneficial effect of Se supplementation to lower inflammation in HD patients remains unknown.…”

Trace element supplementation in hemodialysis patients: a randomized controlled trial

“…Other studies used higher doses, zinc 100 mg/d, apparently without adverse effects [ 15 , 16 ]. There are fewer studies of selenium supplementation in dialysis populations, but 200 and 300 mcg/d were both used in short-term studies of hemodialysis patients, without an increased risk of adverse events [ 11 , 17 , 18 ]. We chose relatively low doses of zinc and selenium because we were concerned about the risk of toxicity.…”

Chronic Kidney Disease as Oxidative Stress- and Inflammatory-Mediated Cardiovascular Disease

“…The activity of antioxidant enzymes is altered by both impaired renal function and dialysis treatment. Interestingly, despite numerous studies in this field, the obtained results are inconclusive, and quite the opposite [67][68][69][70][71][72][73][74][75][76][77][78][79][80][81]. It may be because uremia is a multifactorial process and can be affected by many disturbances.…”

“…The significant impact of trace element supplementation on the increase in antioxidant enzyme activity in this group has not been proven beyond a reasonable doubt. For this reason, the routine administration of zinc or selenium in CKD is currently not recommended [81,90].…”