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Kidney Week

Abstract: PO0463

Association of Plasma Selenium with Renal Function in Hypertensives: Modification by Folate

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Li, Youbao, Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangzhou, China
  • Qin, Xianhui, Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangzhou, China
  • Nie, Jing, Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangzhou, China
  • Liang, Min, Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangzhou, China
  • Hou, Fan Fan, Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangzhou, China
Background

We aimed to investigate the association between plasma selenium (Se) and renal function decline in adults with hypertension and to explore the possible modifiers.

Methods

This was a prospective study, including a total of 935 hypertensive adults from a folic-acid intervention trial (CSPPT) with baseline plasma Se measurements and renal outcome data available. The primary outcome was rapid decline in renal function, defined as an average decline in eGFR ≥5 mL/min/1.73m2 per year.

Results

Over a median follow-up of 4.4 years, the primary outcome occurred in 72 participants. After multivariate-adjusted, there was an inverse association between plasma Se and rapid decline in renal function (per 10-unit increment; OR, 0.85; 95% CI: 0.72, 0.99). Consistently, compared to the lowest tertile of baseline plasma Se (<74.5 μg/L), the highest tertile (89.4~<150 μg/L) was significantly associated with a 60%(0.40; 0.21, 0.79) reduction in the odds of the outcome. A stronger inverse plasma Se-renal function decline association was observed in those received folic acid treatment (per 10-unit increment: OR, 0.70; 95% CI: 0.54, 0.90; P-interaction=0.036) or with a higher baseline folate concentration (≥9.0 ng/mL: 0.59; 0.43, 0.82; P-interaction=0.004).

Conclusion

In China hypertensives with plasma Se <150 μg/L, there was an inverse relationship of plasma Se with the renal function decline, especially in those with folic-acid supplementation or a higher folate level.

Association between plasma Se and the outcome
Plasma selenium, μg/LEvents (%)Adjusted OR (95%CI)*P
Per 10-unit increment72(7.7)0.85(0.72-0.99)0.04
Tertile 1 (<74.5)35(11.2)Ref (1.0) 
Tertile 2 (74.5~<89.4)22(7.1)0.59(0.33-1.07)0.081
Tertile 3 (89.4~<150)15(4.8)0.40(0.21-0.79)0.008

*Adjusted for age, sex, eGFR, treatment group, BMI, MTHFR C677T polymorphisms, proteinuria, SBP, TC, glucose, smoking status at baseline, and averaged SBP during follow-up period.

Subgroup analyses on plasma Se (per 10-unit increment) and the outcome.

Funding

  • Government Support - Non-U.S.