Biological Trace Element Research

, Volume 131, Issue 1, pp 1–12 | Cite as

Selenium, Lead, and Cadmium Levels in Renal Failure Patients in China

  • Bing Chen
  • Ludwig V. Lamberts
  • Geert J. Behets
  • Tingting Zhao
  • Mingxiang Zhou
  • Gang Liu
  • Xianghua Hou
  • Guangju Guan
  • Patrick C. D’Haese


Whole blood and serum samples of Chinese stable chronic renal failure (CRF) patients (n = 81), hemodialysis patients (n = 135), posttransplant patients (n = 60), and subjects with normal renal function (NRF; N = 42) were collected, as well as water and dialysate samples from five dialysis centers. The concentration of selenium (Se), lead (Pb), and cadmium (Cd) was measured by atomic absorption spectrometry. The mean serum Se levels in patients with different degrees of renal failure were significantly lower than those of subjects with NRF (p < 0.01). Pb levels were not increased in renal failure patients, while the Cd levels in patients with various degrees of renal failure were higher than in subjects with NRF (p < 0.05). After correcting the results of Pb and Cd for hematocrit (Hct) however, Pb levels of dialysis patients were also increased. In the dialysis population under study, blood Pb and Cd levels were closely related to the time on dialysis, while contamination of the final dialysate may also contribute to the increased blood Cd and to a less extent Pb levels. Correction for Hct may be recommended to accurately compare blood Pb and Cd levels in dialysis patients and CRF patients with varying degrees of anemia to those of subjects with NRF.


Trace element Selenium Lead Cadmium Chronic renal failure Toxicity Dialysis 



The authors are grateful to Dr Yun SUN (Jinan) and Dr Yan ZHANG (Yantai) in China for providing the samples and questionnaires. This research was performed in the frame of a coculture programme between China and Belgium and has been financed by the China Scholarship Council and the Department of Pathophysiology, University of Antwerp, Belgium. Bing Chen is a student of the Shandong University in China.


  1. 1.
    Zachara BA, Salak A, Koterska D, Manitius J, Wasowicz W, Selenium and glutathione peroxidases in blood of patients with different stages of chronic renal failure, J Trace Elem Med Biol. 17(4), 291–299 (2004).PubMedCrossRefGoogle Scholar
  2. 2.
    Zagrodzki P, Bartoń H, Walas S, Fołta M, Stompór T, Janusz-Grzybowska E, Drozdz M, Sułowicz W, Selenium status indices, laboratory data, and selected biochemical parameters in end-stage renal disease patients, Biol Trace Elem Res. 116(1), 29–41 (2007).PubMedCrossRefGoogle Scholar
  3. 3.
    Lockitch G, Selenium, Clinical significance and analytical concepts, Crit Rev Clin Lab Sci. 27, 483–541 (1989).PubMedCrossRefGoogle Scholar
  4. 4.
    Milly K, Wit L, Diskin C, Tulley R, Selenium in renal failure patients, Nephron. 61, 139–144 (1992).PubMedCrossRefGoogle Scholar
  5. 5.
    Vanholder R, Cornelis R, Dhondt A, Ringoir S, Trace element metabolism in renal disease, In Nutritional Management of Renal disease, Kopple J, Massry SG, eds., Williams and Wilkins, Baltimore, pp. 395–414 (1996).Google Scholar
  6. 6.
    Hampel G, Schaller KH, Rosenmüller M, Oefele C, Selenium-deficiency as contributing factor to anemia and thrombocytopenia in dialysis patients, Life Support Syst. 3 (Suppl 1), 36–40 (1985).PubMedGoogle Scholar
  7. 7.
    Zima T, Tesar V, Mestek O, Nemecek K, Trace elements in end-stage renal disease. 2. Clinical implication of trace elements, Blood Purif. 17, 187–198 (1999).PubMedCrossRefGoogle Scholar
  8. 8.
    Morris-Stiff GJ, Oleesky D, Jurewicz WA, Is selenium deficiency an important risk factor for chronic graft nephropathy? A pilot study, Transplantation. 76(7), 1100–1104 (2003).PubMedCrossRefGoogle Scholar
  9. 9.
    Morris-Stiff GJ, Oleesky DA, Smith SC, Jurewicz WA, Sequential changes in plasma selenium concentration after cadaveric renal transplantation, Br J Surg. 91(3), 339–43 (2004).PubMedCrossRefGoogle Scholar
  10. 10.
    Skarupskiene I, Kuzminskis V, Abdrachmanovas O, Ryselis S, Smalinskiene A, Naginiene R, Laukevicius A, Influence of hemodialysis on changes of trace metals concentrations in blood of patients with end-stage renal failure, Medicina (Kaunas). 39(Suppl 1), 131–138 (2003).Google Scholar
  11. 11.
    Kazi TG, Jalbani N, Kazi N, Jamali MK, Arain MB, Afridi HI, Kandhro A, Pirzado Z, Evaluation of toxic metals in blood and urine samples of chronic renal failure patients, before and after dialysis, Ren Fail. 30 (7), 737–745 (2008).PubMedCrossRefGoogle Scholar
  12. 12.
    Lin JL, Lin-Tan DT, Yen TH, Hsu CW, Jenq CC, Chen KH, Hsu KH, Huang YL, Blood lead levels, malnutrition, inflammation, and mortality in patients with diabetes treated by long-term hemodialysis, Am J Kidney Dis. 51(1), 107–15 (2008).PubMedCrossRefGoogle Scholar
  13. 13.
    Hsu CW, Lin JL, Lin-Tan DT, Yen TH, Huang WH, Ho TC, Huang YL, Yeh LM, Huang LM, Association of environmental cadmium exposure with inflammation and malnutrition in maintenance haemodialysis patients, Nephrol Dial Transplant. (2008 Nov 21) In press.Google Scholar
  14. 14.
    DeSilva PE, Blood lead levels and the haematocrit correction, Ann Occup Hyg. 28 (4), 417–428 (1984).PubMedCrossRefGoogle Scholar
  15. 15.
    Brtkova A, Magalova T, Babinska K and Bederova A, Serum selenium levels in slovak population, Biol Trace Elem Res. 46, 163–171 (1994).PubMedCrossRefGoogle Scholar
  16. 16.
    Lee SH, Huang JW, Hung KY, Leu LJ, Kan YT, Yang CS, Chung Wu D, Huang CL, Chen PY, Chen JS, Chen WY, Trace metals’ abnormalities in hemodialysis patients, relationship with medications, Artificial Organs. 24(11), 841–844 (2000).PubMedCrossRefGoogle Scholar
  17. 17.
    Salonen JT, Alfthan G, Huttunen JK and Puska PP, Association between serum selenium and the risk of cancer, Am J Epidemiol. 120, 342–349 (1984).PubMedGoogle Scholar
  18. 18.
    Willett WC, Polk BF, Morris JS, Stampfer MJ, Pressel S, Rosner B, Taylor JO, Schneider K, Hames CG, Prediagnostic serum selenium and risk of cancer, Lancet. 2, 130–134 (1983).PubMedCrossRefGoogle Scholar
  19. 19.
    Romero CD, Blanco FL, Sanchez PH, Rodriguez E, Majem LS, Serum selenium concentration in a representative sample of the Canarian population, Sci Total Environ. 269, 65–73 (2001).CrossRefGoogle Scholar
  20. 20.
    Dworkin B, Weseley S, Rosenthal WS, Schwartz EM, Weiss L, Diminished blood selenium levels in renal failure patients on dialysis: correlations with nutritional Status, Am J Med Sci. 30, 6–12 (1987).CrossRefGoogle Scholar
  21. 21.
    Zachara BA, Koterska D, Manitius J, Sadowski L, ziedziczko A, Salak A, Wasowicz W, Selenium supplementation to patients with the end stage of chronic renal failure has no effect on the increase of lowered plasma glutathione peroxidase activity, Biol Trace Elem Res. 97, 15–30 (2004).PubMedCrossRefGoogle Scholar
  22. 22.
    Marchante-Gayon JM, Sanchez-Uria JE, Sanz-Mede A, Serum and tissue selenium contents related to renal disease and colon cancer as determined by electrothermal atomic absorption spectrometry, J Trace Elem Med Biol. 10, 229–236 (1996).PubMedGoogle Scholar
  23. 23.
    Saint - Georges MD, Bonnefont DJ, Bourely BA , Correction of selenium deficiency in hemodialyzed patients, Kidney Int. 36(Suppl. 27), S274–277 (1989).Google Scholar
  24. 24.
    Li N, Gao Z, Luo D, Tang X, Chen D, Hu Y, Selenium level in the environment and the population of Zhoukoudian area, Beijing, China, Science of the Total Environment. 381, 105–111 (2007).PubMedCrossRefGoogle Scholar
  25. 25.
    Kafai MR, Ganji V, Sex, age, geographical location, smoking, and alcohol consumption influence serum selenium concentrations in the USA, Third National Health and Nutrition Examination Survey, 1988∼1994, J Trace Elem Med Biol. 17(1), 13–18 (2003).PubMedCrossRefGoogle Scholar
  26. 26.
    Hughes K, Chua LH, Ong CN, Serum selenium in the general population of Singapore, 1993–1995, Ann Acad Med Singap. 27, 520–523 (1998).PubMedGoogle Scholar
  27. 27.
    Jonathan Himmelfarb, Peale Chuang, Gerald Schulman, Hemodialysis, In Brenner& Rector’s the kidney, vol. 2, Barry M. Brenner 8th ed., Saunders, Philadelphia, pp. 1957–2006 (2008).Google Scholar
  28. 28.
    Wu X, Liang Y, Jin T, Ye T, Kong Q, Wang Z, Lei L, Bergdahl IA, Nordberg GF, Renal effects evolution in a Chinese population after reduction of cadmium exposure in rice, Environ Res. 108(2), 233–238 (2008).PubMedCrossRefGoogle Scholar
  29. 29.
    Ratuzny T, Gong Z, Wilke BM, Total concentrations and speciation of heavy metals in soils of the Shenyang Zhangshi Irrigation Area, China, Environ Monit Assess. (2008 Aug 10) In press.Google Scholar
  30. 30.
    Zhai L, Liao X, Chen T, Yan X, Xie H, Wu B, Wang L, Regional assessment of cadmium pollution in agricultural lands and the potential health risk related to intensive mining activities, a case study in Chenzhou City, China, J Environ Sci (China). 20(6), 696–703 (2008).CrossRefGoogle Scholar
  31. 31.
    Hu X, Ding Z, Lead/cadmium contamination and lead isotopic ratios in vegetables grown in peri-urban and mining/smelting contaminated sites in Nanjing, China, Bull Environ Contam Toxicol. 82(1):80–84, (2008 Sep 16).Google Scholar
  32. 32.
    Eum KD, Lee MS, Paek D, Cadmium in blood and hypertension. Sci Total Environ, 407(1), 147–153 (2008).PubMedCrossRefGoogle Scholar
  33. 33.
    Tellez-Plaza M, Navas-Acien A, Crainiceanu CM, Guallar E, Cadmium exposure and hypertension in the 1999–2004 National Health and Nutrition Examination Survey (NHANES), Environ Health Perspect. 116(1), 51–56 (2008).PubMedCrossRefGoogle Scholar
  34. 34.
    Sişman AR, Bülbül M, Coker C, Onvural B, Cadmium exposure in tobacco workers, possible renal effects, J Trace Elem Med Biol. 17(1), 51–55 (2003).PubMedCrossRefGoogle Scholar
  35. 35.
    Bernard A, and Lauwerys R, Cadmium in human population, Experientia. 40, 143–152 (1984).PubMedCrossRefGoogle Scholar
  36. 36.
    World Health Organization, Air quality guidelines for Europe. WHO Regional Publications, European Series No.23, Copenhagen, pp. 242–261 (1987).Google Scholar

Copyright information

© Humana Press Inc. 2009

Authors and Affiliations

  • Bing Chen
    • 1
    • 2
  • Ludwig V. Lamberts
    • 1
  • Geert J. Behets
    • 1
  • Tingting Zhao
    • 3
  • Mingxiang Zhou
    • 3
  • Gang Liu
    • 2
  • Xianghua Hou
    • 1
    • 2
  • Guangju Guan
    • 2
  • Patrick C. D’Haese
    • 1
  1. 1.Laboratory of Pathophysiology, Faculties of Medicine and Biomedical and Pharmaceutical and Veterinary SciencesUniversity of AntwerpAntwerpBelgium
  2. 2.Department of Nephrology, The Second Affiliated HospitalShandong UniversityJinanPeople’s Republic of China
  3. 3.Department of Respiratory MedicineShandong Provincial Chest HospitalJinanPeople’s Republic of China

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