Selenium depletion in hemodialysis patients treated with polysulfone membranes

Background/Aims: Epidemiological, animal and human studies have indicated t hat selenium deficiency is a risk factor for death from malignant diseases. The mechanisms that could modify selenium status may, therefore, be of par ticular interest in hemodialysis patients, considering their high cancer mo rtality rates. We aimed at evaluating the effect of hemodialysis with polys ulfone membranes on selenium status. Methods:Twenty-eight chronically dialy zed patients and 32 age-matched healthy controls were enrolled in the study . Serum and dialysis fluid selenium concentrations, serum total protein, an d hemoglobin concentrations and serum glutathione peroxidase activity were determined before and after the hemodialysis procedure. Results: The (mean +/- SD) serum selenium and total protein concentrations and glutathione per oxidase activities were significantly (p < 0.05) higher in healthy controls (75.9 +/- 8.3 mu g/l, 78 +/- 6 g/l, and 23.8 +/- 4.8 mU/20 mu l, respectiv ely) than in the patients. There was no significant difference between seru m selenium concentration before (63.6 +/- 11.6 mu g/l) and after (64.4 +/- 11.4 mu g/l) hemodialysis sessions, although hemoglobin and total serum pro tein concentrations and serum glutathione peroxidase activities increased ( from 98.5 +/- 1.3 to 114.8 +/- 1.5 g/l, from 64 +/- 8 to 71 +/- 9 g/l, and from 16.8 +/- 1.8 to 18.9 +/- 1.9 mU/20 mu l, respectively) significantly(p < 0.05) during hemodialysis, indicating hemoconcentration. The selenium co ncentration doubled, and protein appeared in the dialysates during dialysis session. The correlation of the selenium concentrations with the protein c oncentrations in the dialysate is significant (p < 0.01) with a Spearman R value of 0.97. Conclusion: The results of the present study suggest that se lenium is lost through the pores of polysulfone membranes during hemodialys is which is associated with their protein permeability. Copyright (C) 2000 S. Karger AG, Basel.