Selenium Metabolism in Patients on Continuous Ambulatory Peritoneal Dialysis

Abstract

Background Selenium is an essential trace element for living organisms. In many publications, researchers express concern about a possible Se deficiency in patients with end-stage chronic renal failure (ESCRF) undergoing continuous ambulatory peritoneal dialysis (CAPD). However, in a number of published articles, the data provide no evidence that patients under CAPD develop Se deficiency. Objective We investigated Se metabolism in ESCRF patients on CAPD. Setting The study was carried out at the Department of Propaedeutic Surgery, Athens University; the Laboratory for Material Analysis of the Nuclear Physics Institute; and the State General Hospital, Athens, Greece. Patients and Methods The study group included 24 patients on CAPD treatment, 14 ESCRF patients, and 17 healthy controls. We measured the Se and Fe content of serum, blood, and erythrocytes. We also measured hematocrit, serum total proteins and albumins, and Se in dialysate effluent. Results As compared with healthy subjects, the ESCRF and CAPD patients exhibited reduced serum concentrations of Se. However, considering the difference in hematocrit values, the total serum-transported Se per liter of blood was close to normal. Erythrocyte Se proved normal for both groups. The measured Se in the spent effluent indicates that patients under CAPD receive approximately 100 μg Se from their daily diet, as normal subjects do. The Se measurement data from the effluent indicate that 90% of the Se carried by the serum is bound to albumins and that only the remaining 10% is in the form of low molecular weight selenate, free to pass the peritoneal membrane. Of the 24 CAPD patients studied, 4 patients (all women) showed extremely low Se serum levels. Data suggest that those low levels are more likely due to the significantly lower serum albumin levels in the 4 patients than to an insufficient dietary intake. Conclusions Data from the present experimental work suggest that patients undergoing CAPD receive the necessary quantities of Se from their regular diet. The data contradict statements in the relevant literature that CAPD patients develop Se deficiency.

Partial dehydration and cryopreservation of Citrus seeds

“…They found that, although serum selenium levels were low in patients with renal failure, there was no correlation between plasma and urinary selenium levels, and urinary selenium excretion was lower than in a control population. Numerous other studies have explored serum or plasma selenium status in renal failure10–16. These have all shown low selenium levels in patients with renal failure; however, there is disagreement as to whether or not the relationship is dialysis dependent and whether selenium levels are lower in patients undergoing peritoneal haemodialysis.…”

Trace Minerals in Patients with End‐Stage Renal Disease

“…Selenium is not removed by PD in significant quantities (100). One study of PD patients suggests that there was no clinical evidence for functional deficiency and that low serum albumin may contribute to low serum measurements, because selenium binds to albumin electrostatically (101).…”

Total reflection X-ray fluorescence selenium analysis after reduction and quartz reflector adsorption

“…X-Ray methods have been used for selenium analysis the last few years as selenium ionization cross section is quite high if an ionization source in the 17-22 keV energy region is used. 7 Total reflection X-ray fluorescence (TXRF) is a rather new technique in elemental analysis. It is an economical method (low cost per sample) that provides reliable analytical results concerning the analyses of trace elements in liquid or solid samples.…”