Inverse Association Between Baseline Plasma Selenium Concentrations and Risks of Renal Function Decline in Hypertensive Adults

Abstract

Background The kidney has the highest level of selenium (Se) in the body, but the role of plasma Se in chronic kidney disease is uncertain. Objective We aimed to investigate the longitudinal association between baseline plasma Se and renal function decline in adults with hypertension and to explore possible effect modifiers. Methods This was a post-hoc analysis of 935 men and women with hypertension aged 40 to 75 years from a folic-acid intervention trial (CSPPT) in China. Baseline plasma Se was analyzed as a continuous variable and as tertiles. The primary outcome was rapid decline in renal function, defined as a mean decline in eGFR ≥5 mL/(min· 1.73m2) per year. Results The median follow-up duration from baseline to outcome was 4.4 years. After multivariate adjustment, there was an inverse association between plasma Se and rapid decline in renal function (per 10-unit increment; OR, 0.85; 95%CI: 0.73, 0.99). When baseline plasma Se was assessed as tertiles, compared to the lowest tertile (<74.5 μg/L), a lower trend of the primary outcome was found in the second tertile (74.5 to <89.4 μg/L; OR, 0.60; 95%CI: 0.34, 1.07) and the highest tertile (89.4 to <150 μg/L; OR, 0.42; 95%CI: 0.22, 0.80) (P for trend = 0.006). Furthermore, the Se-renal association was more pronounced among participants with folic acid treatment or with a higher baseline folate concentration (both P for interaction <0.05). Conclusions In this sample of Chinese adults with hypertension, baseline plasma Se concentrations are inversely associated with the risk of renal function decline.

Preoperative serum selenium predicts acute kidney injury after adult cardiac surgery

“…Previous observational studies demonstrated that patients with CKD had a lower serum Se levels than those of healthy adults. [17,23] Xie et al found that Se intake seemed to have an inverse relationship on CKD development. [16] Zhu et al analyzing 3,063 CKD adults from NHANES database reported that a higher serum selenium concentration could attenuate the risk of all-cause and CVD mortality in patients with CKD, albeit without estimated adequate dose recommendation.…”

Excess selenium intake is associated with microalbuminuria in female but not in male among adults with obesity: Results from NHANES 2009–2018

“…Selenium supplementation can improve the long-term outcome of CKD patients with selenium deficiency ( 36 ). However, a high intake of selenium may injury kidney ( 37 ).…”

Higher serum selenium concentration is associated with lower risk of all-cause and cardiovascular mortality among individuals with chronic kidney disease: A population-based cohort study of NHANES

“…In the general population, the serum selenium concentration associated with minimal mortality is 130-150 (61,62). However, there is an intrinsic conflict between long-term health benefits based on epidemiological evidence and the controversial results of selenium supplementation studies in humans (14, [24][25][26][27][28][29][30][31][32][33]62). Countering this mystery, there are some possible explanations for this problem.…”

“…Insufficient dietary intake of selenium and selenium deficiency are important health challenges that induce Keshan disease, Kashin-Beck disease, autoimmune diseases, and CVDs (14, 20, 21). However, existing evidence reveals that high selenium levels have a beneficial impact on the incidence of various diseases in the general population, whereas supplementation with selenium has demonstrated controversial results (14, [22][23][24][25][26][27][28][29][30][31][32][33]. Among patients with CKD with extremely high pro-inflammatory status and oxidative stress, who always have abnormal metabolisms of various trace elements, investigations regarding the beneficial effects of selenium are controversial and limited.…”

“…Among patients with CKD with extremely high pro-inflammatory status and oxidative stress, who always have abnormal metabolisms of various trace elements, investigations regarding the beneficial effects of selenium are controversial and limited. One prospective study suggested that the serum selenium levels of patients with hemodialysis were similar to those of the general population (34), whereas three observational studies revealed that the serum selenium levels of patients with CKD were lower than those of healthy adults (28,30,32). Some intervention studies found that selenium supplementation may play a beneficial role in patients with CKD (35, 36), while a randomized controlled trial (RCT) indicated that oral administration of selenium does not decrease the prevalence of type 2 diabetes and leads to an increased risk of this disease during the follow-up period (37).…”