The following article features coverage from the American Society of Nephrology’s Kidney Week 2021. Click here to read more of Renal & Urology News’s conference coverage.

Low selenium levels are associated with resistance to erythropoiesis-stimulating agents (ESAs), new study findings suggest. The preliminary data were presented at the American Society of Nephrology’s Kidney Week 2021.

In the study of 174 Japanese patients receiving hemodialysis, 88 patients (51%) had serum selenium levels of less than 10.5 μg/dL at the lower limit of normal. In an analysis of the 146 patients who received ESAs for anemia, lower serum selenium levels significantly correlated with higher ESA-resistance index (ERI), Shigeru Shibata, MD, PhD, of Teikyo University School of Medicine in Tokyo, Japan, reported.

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A greater proportion of patients in the low vs normal selenium group received ESAs. Hemoglobin levels and use of iron therapy were similar between groups. Patients did not differ significantly in age, sex, body mass index, dialysis vintage, or comorbidities.

“Selenium is a trace element that is present in the body at a low level of 10-20 mg in total. It modulates diverse physiological processes, such as immune responses and cardiovascular function,” Dr Shibata explained in an interview with Renal & Urology News. Previous studies also indicate that selenium and selenoproteins are involved in erythropoiesis.

“Appropriate selenium intake or supplementation may reduce the demand for ESAs in advanced CKD patients and merits further investigation.”


Yasukawa M, Arai S, Nagura M, et al. Association of serum selenium levels with the response to erythropoiesis-stimulating agents in maintenance hemodialysis patients. Presented at: Kidney Week 2021; November 2-7, 2021.Abstract: PO1744.