Suboptimal selenium status may impair the antioxidant defense system in patients undergoing hemodialysis, compromising the selenoenzyme glutathione peroxidase activity. To evaluate the association between the duration of hemodialysis, nutritional selenium status, glutathione peroxidase activity (GPx), and thiobarbituric acid reactive substance (TBARS) levels in patients with chronic renal failure undergoing hemodialysis in a region of selenium-rich soils (Ceará, Northeast Brazil). The case-control study of 75 individuals aged 18 to 88 years was allocated between two groups: hemodialysis (n = 41) and control (n = 34). Plasma and erythrocytes selenium levels were determined by inductively coupled plasma optical emission spectrometry. The GPx activity and TBARS levels were also evaluated. In addition, the hemodialysis group was stratified according to the duration of treatment (≤ 59 months and ≥ 60 months). The Mann-Whitney test, Student's t test, and Pearson's or Spearman's correlation were applied according to the data distribution. Moreover, a quantile regression was performed. The significance level (p) was < 0.05. The hemodialysis group had lower selenium levels in their plasma and erythrocytes than the control group (p < 0.001). However, there was no difference in the GPx activity between the groups. Furthermore, an association between the hemodialysis group and selenium levels in plasma (coefficient - 16,343, p < 0.001) and erythrocytes (coefficient - 7839, p = 0.003) was observed by quantile regression, independent of age, sex, and body-mass index. In individuals who had undergone treatment for 60 months or more, GPx activity was lower (p = 0.026) and TBARS levels higher (p = 0.011) than in those who had undergone treatment for less than 60 months. The status of selenium was reduced in the hemodialysis group compared to the control group. The lower GPx activity and higher levels of TBARS in individuals who had undergone treatment for 60 months or more correlated with greater oxidative stress.
Keywords: Chronic renal failure; Glutathione peroxidase; Renal dialysis; Selenium.