Serum selenium level and its relation with inflammatory profile in hemodialysis children

Abstract

Introduction: Chronic kidney disease (CKD) is described by structural or functional defects staying for three months. End-stage kidney disease (ESKD) patients undergoing renal replacement therapy (RRT) face complications and increased susceptibility to infections due to their compromised immune system. In addition, malnutrition and chronic inflammatory conditions are prevalent in CKD patients. Selenium, an essential trace element, plays a crucial role as a cofactor in antioxidant enzymes like glutathione peroxidase (GPX), contributing to vascular endothelial function. Selenium deficiency in patients with ESKD may intensify oxidative stress, increase susceptibility to cardiovascular complications, and impact mortality rates. Despite the significance of selenium in this context, studies on its levels in children undergoing hemodialysis (HD) are limited. Objectives: This study assessed serum selenium levels in children undergoing HD, compared with healthy children. Furthermore, we sought to establish correlations between selenium levels and inflammatory profiles in the HD group. Patients and Methods: An observational cross-sectional study was conducted with 30 pediatric patients with ESKD undergoing HD (HD group) and 50 healthy children (control group) in Tehran, Iran. Blood samples were collected from both groups, and serum selenium levels along with inflammatory markers were analyzed. The inclusion criteria encompassed pediatric ESKD patients undergoing HD for at least six months without recent inflammation or infections. The exclusion criteria comprised active infections, immunodeficiency syndromes, and corticosteroid therapy. Statistical analyses were performed using SPSS statistics. Results: Significant differences were observed in serum selenium levels between the HD and control groups (P=0.039). Correlation analysis disclosed a direct relationship among selenium levels and participant age (r = 0.235, P=0.036), with no significant difference between genders. Notably, significant correlations were found between selenium levels and erythrocyte sedimentation rate (ESR) and platelet-to-lymphocyte ratio (PLR). In contrast, no significant correlation between selenium levels and other inflammatory profiles was established. Conclusion: This study underscores the importance of assessing serum selenium levels in pediatric ESKD patients undergoing HD. Understanding the interplay between selenium deficiency and inflammatory profiles can inform interventions aimed at improving outcomes and reducing complications in this vulnerable population. Further researches are necessary to explain these associations and to explore possible therapeutic interventions.