El selenio y la desnutrición e inflamación. Estudio preliminar en enfermedad renal crónica avanzada

Introduction

Protein-energy wasting and chronic inflammation in renal patients are related to an increase in mortality, as well as the occurrence of unresponsive anaemia and mineral and bone disease. The increase in oxidative stress, in which selenium plays a role, is among the causes of malnutrition and inflammation. The relationship between plasma or serum selenium and malnutrition and inflammation in adult patients undergoing renal replacement therapy is investigated.

Material and methods

Cross-sectional observational study that included 85 plasma specimens from patients on dialysis, and 118 from control subjects. Selenium and biochemical markers of nutrition, inflammation, and co-morbidities were measured. The comparisons were using Mann-Whitney, ANOVA and chi-squared tests. Correlations were estimated using Spearman's Rho.

Results

The median selenium was 58.2 μg/L in the patient group, and 89.3 μg/L in the control group (p < .001). Selenium correlated with albumin (Rho = 0.440), cholesterol (Rho = 0.278) and creatinine (Rho = 0.367) in the patient group. Patients classification based on selenium level led to significant differences between the 2 groups in time on dialysis (p < .018), albumin (p < .003), creatinine (p < .004), cholesterol (p < .038) and phosphate (p < .025).

Conclusions

Selenium positively correlates with nutritional markers in the group of patient group. According to selenium level, there are 2 populations differentiated by nutritional status and time on dialysis. Plasma selenium is a potentially useful marker for protein-energy wasting diagnosis.