Low selenium intake is associated with risk of all-cause mortality in kidney transplant recipients

Author:

Yepes-Calderón Manuela1ORCID,Kremer Daan1,Post Adrian1,Sotomayor Camilo G12,Seidel Ulrike3,Huebbe Patricia3,Knobbe Tim J1,Lüersen Kai3,Eisenga Michele F1,Corpeleijn Eva4,de Borst Martin H1,Navis Gerjan J1,Rimbach Gerald3,Bakker Stephan J L1

Affiliation:

1. Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen , Groningen, Groningen , The Netherlands

2. Institute of Biomedical Sciences, Faculty of Medicine, University of Chile , Santiago de Chile, Santiago , Chile

3. Institute of Human Nutrition and Food Science, University of Kiel , Kiel, Schleswig-Holstein , Germany

4. Department of Epidemiology, University Medical Center Groningen , Groningen, Groningen , The Netherlands

Abstract

ABSTRACT Background Deficiency of the essential trace element selenium is common in kidney transplant recipients (KTR), potentially hampering antioxidant and anti-inflammatory defence. Whether this impacts the long-term outcomes of KTR remains unknown. We investigated the association of urinary selenium excretion, a biomarker of selenium intake, with all-cause mortality; and its dietary determinants. Methods In this cohort study, outpatient KTR with a functioning graft for longer than 1 year were recruited (2008–11). Baseline 24-h urinary selenium excretion was measured by mass spectrometry. Diet was assessed by a 177-item food frequency questionnaire, and protein intake was calculated by the Maroni equation. Multivariable linear and Cox regression analyses were performed. Results In 693 KTR (43% men, 52 ± 12 years), baseline urinary selenium excretion was 18.8 (interquartile range 15.1–23.4) μg/24-h. During a median follow-up of 8 years, 229 (33%) KTR died. KTR in the first tertile of urinary selenium excretion, compared with those in the third, had over a 2-fold risk of all-cause mortality [hazard ratio 2.36 (95% confidence interval 1.70–3.28); P < .001], independent of multiple potential confounders including time since transplantation and plasma albumin concentration. The most important dietary determinant of urinary selenium excretion was protein intake (Standardized β 0.49, P < .001). Conclusions Relatively low selenium intake is associated with a higher risk of all-cause mortality in KTR. Dietary protein intake is its most important determinant. Further research is required to evaluate the potential benefit of accounting for selenium intake in the care of KTR, particularly among those with low protein intake.

Funder

Institute Food and Nutrition

Dutch Ministry of Economic Affairs and Climate Policy

Publisher

Oxford University Press (OUP)

Subject

Transplantation,Nephrology

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