Selenium and Coenzyme Q10 Supplementation Improves Renal Function in Elderly Deficient in Selenium: Observational Results and Results from a Subgroup Analysis of a Prospective Randomised Double-Blind Placebo-Controlled Trial.

Urban Alehagen,Kerstin Brismar,Anders Larsson,Jan Aaseth,Jan Alexander

doi:10.3390/nu12123780

Abstract

A low selenium intake is found in European countries, and is associated with increased cardiovascular mortality. There is an association between selenium level and the severity of kidney disease. An association between inflammation and selenium intake is also reported. The coenzyme Q10 level is decreased in kidney disease. The aim of this study was to examine a possible association between selenium and renal function in an elderly population low in selenium and coenzyme Q10, and the impact of intervention with selenium and coenzyme Q10 on the renal function. The association between selenium status and creatinine was studied in 589 elderly persons. In 215 of these (mean age 71 years) a randomised double-blind placebo-controlled prospective trial with selenium yeast (200 µg/day) and coenzyme Q10 (200 mg/day) (n = 117) or placebo (n = 98) was conducted. Renal function was determined using measures of glomerular function at the start and after 48 months. The follow-up time was 5.1 years. All individuals were low on selenium (mean 67 μg/L (SD 16.8)). The changes in renal function were evaluated by measurement of creatinine, cystatin-C, and the use of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) algorithm, and by the use of T-tests, repeated measures of variance and ANCOVA analyses. An association between low selenium status and impaired renal function was observed. Intervention causes a significantly lower serum creatinine, and cystatin-C concentration in the active treatment group compared with those on placebo (p = 0.0002 and p = 0.001 resp.). The evaluation with CKD-EPI based on both creatinine and cystatin-C showed a corresponding significant difference (p < 0.0001). All validations showed corresponding significant differences. In individuals with a deficiency of selenium and coenzyme Q10, low selenium status is related to impaired renal function, and thus supplementation with selenium and coenzyme Q10 results in significantly improved renal function as seen from creatinine and cystatin-C and through the CKD-EPI algorithm. The explanation could be related to positive effects on inflammation and oxidative stress as a result of the supplementation.

Highlights

Renal function is of fundamental importance to the health of the body
The aim of the present study was two-fold: First, to investigate whether selenium status is associated with renal function in an elderly Swedish community-living population, and secondly, in a sub-study to investigate a possible influence of supplementation over four years with selenium and coenzyme Q10 on the renal function
As a first step we wanted to establish if there was any relation between renal function and selenium before any intervention

Summary

Introduction

Renal function is of fundamental importance to the health of the body. In states with an impaired renal function, the impacts can be seen in several organ systems. The cardiovascular system is one where an impaired renal function will have important effects both in terms of prognosis, and in the choice of treatment in most heart diseases. As inflammation is one of the major drivers for most heart diseases [2,3,4], it is interesting to note that most renal diseases are associated with inflammation [5,6,7]. In early stages of renal dysfunction, when the glomerular function is still intact, systemic and local inflammation leads to downregulation of molecules that have renal protective effects [8]

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