A Cross-Sectional Study of Plasma Manganese and Selenium Levels in Paediatric CKD Patients

Abstract

Abstract Introduction: Manganese (Mn) and Selenium (Se) deficiencies are noted in adult patients with chronic kidney disease (CKD). However, levels of these trace elements have not been well studied in the pediatric CKD population. We determined the Mn and Se levels in a single-institution cohort of paediatric patients with CKD. Methods: Ancillary cross-sectional study to a prospective longitudinal randomized control trial on zinc supplementation, which included 42 children and adolescents aged 0 to 19 years with CKD stages I to IV not on dialysis, who had 1-6 trace element measurements. Cystatin C estimated glomerular filtration rate (eGFR) was calculated using the Filler formula. Plasma Mn and Se levels were measured, and anthropomorphic data/blood parameters were collected from electronic health records. Results: There were 96 Mn and Se levels in 42 patients. The median Mn concentration was 12.61 nmol/L [10.08, 16.42] with a trend towards lower values with lower eGFR (p=0.0367 one-sided). Mn z-scores were significantly lower than the general paediatric reference population. The mean Se level was 1.661±0.3399 µmol/L with a significant positive correlation with eGFR (p=0.0159, r=0.366). However, only 4 patients with low eGFR had abnormally low Se levels. Conclusion: This single-institution ancillary study of children with CKD demonstrates a significant decrease in Se levels with decreasing eGFR, but no significant difference between mean Se z-scores of our cohort and the reference population. There was no significant relationship between Mn levels and eGFR however the mean Mn z-score was significantly lower than the theoretical mean. Clinical Trial Registration: clinicaltrials.gov, NCT02126293, https://clinicaltrials.gov/ct2/show/NCT02126293. Date: April 30, 2014