Objective

The objectives of the study were to determine whether low plasma selenium levels (<63 μg/L according to population-based reference interval) were associated with poorer survival among adult patients with end-stage renal disease (ESRD) on dialysis treatment and to study whether plasma selenium behaved as a biomarker of mortality risk independent of other monitored biochemical markers.

Methods

This is a retrospective observational cohort study that included 85 patients with ESRD on 3 modalities of dialysis, with a plasma selenium test performed 5-6 years before the study.

Results

Patients with low selenium showed an increased risk of all-cause mortality (hazard ratio = 2.952, 95% CI 1.402-6.217) compared with patients with normal or high selenium (>118 μg/L), according to a Cox multivariate model that included age and history of cardiovascular disease as covariates. Patients with low selenium had an increased risk of all-cause mortality (hazard ratio = 2.894, 95% CI 1.457-5.751) according to a model that included age, anemia, and low albumin as covariates. Low albumin patients had an increased risk of having low plasma selenium (odds ratio = 5.778, 95% CI 2.212-15.098).

Conclusions

Low plasma selenium group's survival was significantly lower than that of the group with normoselenemia or hyperselenemia. Plasma selenium behaved as a biomarker of mortality risk independent of other biochemical markers usually monitored in patients with ESRD.

中文翻译：

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硒和终末期肾病的全因死亡率。回顾性观察队列研究

客观的

该研究的目的是确定低血浆硒水平（根据基于人群的参考区间 <63 μg/L）是否与接受透析治疗的终末期肾病 (ESRD) 成年患者的较差生存相关，并研究血浆硒是否作为独立于其他监测生化标志物的死亡风险生物标志物。

方法

这是一项回顾性观察队列研究，其中包括 85 名接受 3 种透析方式的 ESRD 患者，并在研究前 5-6 年进行了血浆硒测试。

结果

根据 Cox 多变量模型，与硒含量正常或硒含量高 (>118 μg/L) 的患者相比，硒含量低的患者的全因死亡率风险增加（风险比 = 2.952，95% CI 1.402-6.217）。年龄和心血管疾病史作为协变量。根据包括年龄、贫血和低白蛋白作为协变量的模型，低硒患者的全因死亡风险增加（风险比 = 2.894，95% CI 1.457-5.751）。低白蛋白患者血浆硒低的风险增加（优势比 = 5.778，95% CI 2.212-15.098）。

结论

低血浆硒组的存活率明显低于正常硒血症或高硒血症组。血浆硒作为死亡风险的生物标志物，独立于 ESRD 患者通常监测的其他生化标志物。