LOW PLATELET GLUTATHIONE-PEROXIDASE ACTIVITY AND SERUM SELENIUM CONCENTRATION IN PATIENTS WITH CHRONIC-RENAL-FAILURE - RELATIONS TO DIALYSIS TREATMENTS, DIET AND CARDIOVASCULAR COMPLICATIONS

1. Selenium status was investigated in patients with chronic renal fai lure, with special regard to its relations to the dialysis treatments, dietary habits and clinical signs of atherosclerosis. 2. Serum seleni um concentration and platelet glutathione peroxidase activity were mea sured in 45 patients with chronic renal failure subdivided into three groups according to the type of treatment: 15 non-dialysed, 15 on haem odialysis, 15 on continuous ambulatory peritoneal dialysis. A 7-day di et history was carried out in all patients. Seventeen of the patients with chronic renal failure had clinically overt cardiovascular disease . Forty-five age-matched healthy subjects were considered as controls. 3. Both serum selenium concentration and platelet glutathione peroxid ase were significantly reduced in all patients with chronic renal fail ure compared with control subjects; a direct and significant correlati on was found between the two parameters. No differences in selenium st atus were observed among the non-dialysed, haemodialysis and continuou s ambulatory peritoneal dialysis groups. No correlation between total calorie or protein intakes and selenium indices were observed. The chr onic renal failure patients with cardiovascular complications showed a further significant reduction in both serum selenium concentration an d platelet glutathione peroxidase activity as compared with the patien ts without cardiovascular complications; these two groups were similar with respect to the other well-known cardiovascular risk factors (age , smoking, plasma lipids, hypertension, body mass index). 4. It is con cluded that a low selenium concentration is present in chronic renal f ailure, which is independent of dialysis and is accompanied by biologi cal repercussion in terms of reduced platelet glutathione peroxidase a ctivity. It may represent a previously unrecognized cofactor favouring the 'accelerated' atherosclerosis of patients with chronic renal fail ure.