Teixeira, Joana Daniela Tinoco2024-09-022024-07-24http://hdl.handle.net/10362/171019Background: The progression of chronic kidney disease (CKD) is associated with chronic systemic inflammation and an increased risk of mortality from cardiovascular disease. Selenium (Se) levels are lower in hemodialysis (HD) patients and only these low levels have been directly and inversely related to mortality and appear to increase susceptibility to oxidative stress. Se supplementation may be useful in increasing plasma Se levels, but it is unknown if Se supplementation can improve any clinical or health-related outcomes. Aim: Investigate the effect of selenium supplementation on the inflammatory profile and oxidative stress markers in adult patients with chronic kidney disease undergoing hemodialysis. Methodology: A literature search was carried out on PubMed, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials databases in October 2023, following a pre-specified protocol (PROSPERO). Data extraction was performed by two independent investigators. Results: From 2481 articles identified, five randomized controlled trials were eligible and included in the systematic review. The impact of selenium supplementation on inflammatory and oxidative stress markers was found to be inconsistent. Although CRP concentrations remained stable in HD patients, a decrease was observed in individuals with diabetes. Conversely, hs-CRP concentrations showed no notable changes across the studies. Regarding interleukins, there was a decrease in IL-1 gene expression and no changes in IL-8 gene expression, but in one study selenium supplementation prevented an increase in IL-6 levels. Additionally, TNF-α gene expression decreased. Notably, serum concentrations of ferritin, iron, and transferrin remained unaffected. Similarly, ESR concentrations showed no statistically significant alterations. Regarding oxidative stress markers, MDA concentrations decreased in one study while remaining stable in another. Furthermore, homocysteine concentrations did not display substantial fluctuations in HD patients. Conclusion: Based on the evidence gathered in this systematic review, it remains uncertain whether selenium supplementation affects inflammatory markers and oxidative stress in hemodialysis patients. Additional research is imperative to provide definitive guidance to healthcare professionals given the significant cardiovascular implications in this population.engSelenium supplementationInflammatory markersInflammationOxidative stressChronic Kidney DiseaseHemodialysismaster thesis203682211