Comparison Of Plasma Selenium Levels And Nutritional Status Between Hemodialysis And Peritoneal Dialysis Patients

Objective:By comparing the plasma selenium levels and nutritional status of hemodialysis(HD)and peritoneal dialysis(PD)patients,the effect of different dialysis modalities on patients’ micronutrient selenium and nutritional status was analyzed,and the relationship between plasma selenium levels and the nutritional status of dialysis patients was explored.Methods:A total of 151 patients on dialysis,98 on PD and 53 on HD,were enrolled in the study and grouped according to the mode of dialysis.Nutritional status was determined by subjective global assessment(SGA)and plasma selenium levels were measured by atomic absorption spectrometry.Clinical data and various biochemical test results were collected from all patients for analysis.Results:1.Diastolic blood pressure,pre-albumin,lipids and creatinine were higher in the PD group than in the HD group(p<0.05),and the proportion of diabetic patients was lower in the PD group than in the HD group(p<0.05).2.According to the SGA scoring system,52(53.1 %)patients in the PD group had good nutritional status(score A)and 20(37.7%)patients in the HD group had good nutritional status(score A).The distribution of the patients’ SGA nutritional assessment results differed between the PD and HD groups and the difference was statistically significant(p<0.05),and the nutritional status of the patients in the PD group was better than the HD group.3.The plasma selenium level was 138.56±10.65ug/L in the PD group and 134.77±9.90ug/L in the HD group,the difference was statistically significant(p<0.05).4.Plasma selenium levels differed across nutritional status and the differences were statistically significant(p<0.05;p<0.001).A further two-by-two comparison of blood selenium levels in the three different nutritional status revealed that there was a significant difference in blood selenium levels between score A and severely malnourished(score C)in the HD group(p<0.05)The results of the two-by-two comparison in the PD group were statistically different in all three nutritional status(p<0.05).5.Further correlation analysis showed that selenium levels in dialysis patients were positively correlated with their nutritional status(r = 0.414,p<0.001),negatively correlated with C-reactive protein(CRP)(r =-0.184,p<0.05),and there was no correlation with White blood cells(WBC)and Neutrophil-to-lymphocyte ratio(NLR).Conclusions:This study shows that malnutrition is common in dialysis patients and that PD patients have a better nutritional status than HD patients.Plasma selenium levels were significantly higher in PD patients than in HD patients and there was a positive correlation between plasma selenium levels and the nutritional status of dialysis patients.