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Selenium is a trace element which is deficient in hemodialysis patients .The aim of this study is to evaluate the effect of selenium supplementation on oxidative, inflammatory and nutritional markers in hemodialysis patients .
Hemodialysis patients from both genders with the age range of 17-85 years from two hemodialysis centers in Shiraz participated in this study . 80 patients were eligible for participation. We included the ones who were dialyzed at least twice a week and had undergone dialysis at least for 3 months. Subjects were excluded if they were prescribed any multivitamins or immunosuppressive drugs or if they had been hospitalized in the previous month, we also excluded the ones who were pregnant or had active infections. Patients with diabetes or hypertension were eligible for entry into the trial. All the patients signed the written consent for participating in the study. The local ethics committee reviewed and approved the study protocol.
Initially, data regarding age, duration of hemodialysis, weight, height, and other characteristics such as underlying renal disorder and some of the drugs taken were recorded. Nutritional status was evaluated using 24-hour recall and subjective global assessment and quality of life was also evaluated using SF-36 questionnaire for every patient at the beginning of the study and after 3 months.
First of all, 10cc blood samples were taken from every patient. The blood taken was from the patient's arm used for hemodialysis cannula just before the beginning of the hemodialysis procedure. The serum was separated by centrifugation at 3000 g/min for 5 min and stored at -20°C until their lipoprotein, malondialdehyde, interleukin-6, c-reactive protein, calcium, phosphorus and parathyroid hormone content were analyzed. Then all the patients were divided into case and control groups using balanced block method.
Every patient from the control group received a capsule a day which was made of starch during the 3-month trial period and they were followed in this period. On the other hand, the patients in the experimental group received 200 microgram selenium in the form of selenium yeast (a capsule a day) for three months. The patients were followed for 3 months. Then another blood sample was taken from every patient for the final analysis. Overall, 16 patients were excluded after recruitment because of infection, hospitalization, death , etc. . MDA concentration was estimated using the modified thiobarbituric acid method(spectrophotometric method), described by Mostafavipour and colleagues**. It was reported in micromoul per liter.
The levels of IL-6 were confirmed with single-analyte ELISA from biosource company(Biosource Europe S.A.). This method is a solid phase Enzyme Amplified Sensitivity Immunoassay performed on microtiterplate.
Serum c-reactive protein was measured using ELISA kits from IBL company. Serum phosphorus and total calcium and serum lipoproteins and serum albumin were also determined by standard automated techniques. The normal ranges for serum phosphorus and calcium were 3.0-4.5 mg/dL and 8.8-10.5 mg/dL, respectively.
The Biomerica Intact-PTH ELISA which is a two-site ELISA was used for quantitative determination of intact PTH in patients' serum.
After recording the data, statistical analysis was done. The Data were expressed as mean ± SD. Normally distributed data were analyzed with paired t-tests for comparisons between values befor and after intervention in each group; skewed data were analysed with Wilcoxon ranked test. Comparisons between values in the two groups after intervention were done with independent sample t-test for normally distributed data and Mann-Whitney U test for skewed data. P-values < 0.05 were considered significant. Statistical analysis was performed using SPSS 15.0 for Windows statistical software.
Allocation: Randomized, Control: Placebo Control, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver), Primary Purpose: Treatment
selenium yeast, placebo capsules
Shiraz University of Medical Sciences,School of health and nutrition, nutrition department
Iran, Islamic Republic of
Shiraz University of Medical Sciences
Published on BioPortfolio: 2014-08-27T03:12:48-0400
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