Anadón Ruiz Aránzazu, Martín Jiménez Elena, Bermejo-Barrera Pilar, Lozano Rafael, Seijas Victoria Martínez-Echevarría
Faculty of Pharmacy, Department of Inorganic Chemistry, Universidad Complutense de Madrid, Madrid, Spain.
Biochemistry Laboratory, Hospital Universitario Severo Ochoa, Leganés, Spain.
J Ren Nutr. 2020 Nov;30(6):484-492. doi: 10.1053/j.jrn.2020.02.006. Epub 2020 Apr 8.
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.
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.
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).
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.
本研究的目的是确定血浆硒水平低（根据基于人群的参考区间<63μg/L）是否与接受透析治疗的终末期肾病（ESRD）成年患者较差的生存率相关，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。
这是一项回顾性观察队列研究，纳入了85例接受3种透析方式的ESRD患者，在研究前5 - 6年进行了血浆硒检测。
根据包含年龄和心血管疾病史作为协变量的Cox多变量模型，与硒正常或高（>118μg/L）的患者相比，低硒患者全因死亡风险增加（风险比 = 2.952，95%CI 1.402 - 6.217）。根据包含年龄、贫血和低白蛋白作为协变量的模型，低硒患者全因死亡风险增加（风险比 = 2.894，95%CI 1.457 - 5.751）。低白蛋白患者血浆硒水平低的风险增加（优势比 = 5.778，95%CI 2.212 - 15.098）。
血浆硒水平低的组的生存率显著低于正常硒血症或高硒血症组。血浆硒作为独立于ESRD患者通常监测的其他生化标志物的死亡风险生物标志物。
