GEOGRAPHIC FACTORS AND PLASMA SELENIUM IN UREMIA AND DIALYSIS

The importance of selenium (Se) as an essential trace element for man has been increasingly recognized. Blood Se levels in chronic uremic pa tients are frequently reported to be lower than in controls. Definitiv e determination of the Se status in uremic patients, however, is hampe red by the wide range of blood Se content in humans from different par ts of the world. The present study was designed to assess and compare the Se status in two European populations from Restock (Germany) and C hieti (Italy). Plasma Se levels were evaluated in healthy controls, ch ronic renal failure nondialyzed patients (CRF) and hemodialysis patien ts (HD). All Se determinations were performed in a single laboratory. The Se concentration was significantly higher (p < 0.005) in Italian h ealthy controls than in German healthy controls. In contrast, Se level s were similar in both CRF and HD patients from both cities. In both c ountries, the Se concentration in CRF and HD patients was significantl y lower (p < 0.001) than in their corresponding controls, but no diffe rence between CRF and HD was found. CRF and HD patients from the two c ountries showed quite similar laboratory and anthropometric data. In C RF patients in Chieti, a significant (p < 0.05) negative correlation b etween plasma Se and serum creatinine was found. In both HD groups, th e length of time on HD and type of membrane dialyzer used did not infl uence the Se status. A significant positive correlation (p < 0.01) bet ween Se levels and the protein catabolic rate was found in both HD gro ups. Uremia seems to be a strong factor which overrules the difference in Se levels that is present in healthy adults from different Europea n countries. Uremia in itself may influence and level the Se concentra tion in patients with geographic diversity.