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Abstract: PO1744

Association of Serum Selenium Levels with the Response to Erythropoiesis-Stimulating Agents in Maintenance Hemodialysis Patients

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Yasukawa, Minoru, Teikyo Daigaku Igakubu Daigakuin Igaku Kenkyuka, Itabashi-ku, Tokyo, Japan
  • Arai, Shigeyuki, Teikyo Daigaku Igakubu Daigakuin Igaku Kenkyuka, Itabashi-ku, Tokyo, Japan
  • Nagura, Michito, Teikyo Daigaku Igakubu Daigakuin Igaku Kenkyuka, Itabashi-ku, Tokyo, Japan
  • Hirohama, Daigoro, Teikyo Daigaku Igakubu Daigakuin Igaku Kenkyuka, Itabashi-ku, Tokyo, Japan
  • Yamazaki, Osamu, Teikyo Daigaku Igakubu Daigakuin Igaku Kenkyuka, Itabashi-ku, Tokyo, Japan
  • Tamura, Yoshifuru, Teikyo Daigaku Igakubu Daigakuin Igaku Kenkyuka, Itabashi-ku, Tokyo, Japan
  • Fujigaki, Yoshihide, Teikyo Daigaku Igakubu Daigakuin Igaku Kenkyuka, Itabashi-ku, Tokyo, Japan
  • Shibata, Shigeru, Teikyo Daigaku Igakubu Daigakuin Igaku Kenkyuka, Itabashi-ku, Tokyo, Japan
Background

Reduced response to erythropoiesis-stimulating agent (ESA) has been shown to be associated with poor outcomes in maintenance hemodialysis (MHD) patients. Selenium is a trace element that modulates diverse physiological processes, such as immune responses and cardiovascular function. Previous studies also indicate that selenium and selenoproteins are involved in erythropoiesis. However, its role in the control of anemia in chronic kidney disease patients remains unclear. In this study, we determined serum selenium levels in MHD patients and analyzed their association with hemoglobin levels and the doses of ESA.

Methods

The study included 174 patients who received MHD from four dialysis facilities. We obtained data on demographics, laboratory, comorbidities, hemodialysis prescription and medication by medical record abstraction. Concentration of selenium was measured in serum using ICP-MS.

Results

The mean age was 67.2 years, 77% were male, and 44% of patients received dialysis at least for five years. The average serum selenium concentrations in our cohort were 10.7 ± 2.9 μg/dL, and 88 patients (51%) had a selenium levels of less than 10.5 μg/dL (a lower limit of normal serum selenium levels for adult Japanese population). Patient characteristics, including age, sex, BMI, dialysis vintage, and comorbidities were not significantly different between the low selenium (Low) group and normal selenium (Normal) group. However, the percentage of patients receiving ESA tended to be higher in Low group than in Normal group, whereas hemoglobin levels as well as percentage of patients receiving iron therapy were similar between the groups. In a subgroup analysis involving 146 patients who received ESA, we found a significant negative correlation between serum selenium levels and ESA-resistance index (ERI) (r = -0.25, p = 0.002).

Conclusion

Our study indicates that low levels of serum selenium are associated with poor response to ESA. The relationship between selenium and response to ESA in MHD patients merits further evaluation in larger populations.