Selenoprotein P Deficiency Is Associated with Early Signs of Kidney Disease and Hospitalization Risk in Heart Failure.

The majority of acute HF patients in this cohort had selenium deficiency and a substantial proportion had SGHS.

• Study included 320 patients with SELENOP measurements (mean age 75 years, 69% male).
• 58% of patients had selenium deficiency, defined as serum Se < 70 µg/L.
• 30% of patients had selective glomerular hypofiltration syndrome (SGHS), defined by a cystatin C-based eGFR < 0.7 of creatinine-based eGFR.
• Total cohort for kidney hospitalization analysis comprised 570 patients hospitalized for acute HF.

Higher SELENOP levels were associated with significantly lower odds of having SGHS at baseline.

• Odds ratio for SGHS per unit increase in SELENOP: OR 0.69; p = 0.002.
• Association was evaluated using logistic regression adjusted for age, sex, blood pressure, BMI, eGFR, and NT-proBNP.
• SGHS signals early kidney dysfunction and is known to worsen HF outcomes.

Higher SELENOP levels were associated with reduced risk of hospitalization for AKI or CKD during follow-up.

• Median follow-up was 43 months.
• 28 patients were hospitalized for kidney disease (ICD-10 N17-N19) during follow-up.
• HR for combined AKI or CKD hospitalization per unit increase in SELENOP: HR 0.60; p = 0.010.
• Association was evaluated using Cox regression adjusted for age, sex, blood pressure, BMI, eGFR, and NT-proBNP.

Higher SELENOP levels were particularly strongly associated with reduced risk of AKI hospitalization.

• HR for AKI hospitalization per unit increase in SELENOP: HR 0.42; p = 0.002.
• This association was stronger than the combined AKI/CKD hospitalization risk (HR 0.60).
• Kidney hospitalizations were identified from regional registries using ICD-10 codes N17-N19.

SELENOP deficiency below a threshold of 3.23 mg/L predicted AKI hospitalization.

• SELENOP deficiency defined as < 3.23 mg/L was associated with AKI hospitalization: HR 4.02; p = 0.035.
• This threshold-based analysis provided a clinically applicable cutoff for identifying high-risk patients.
• The finding suggests a specific SELENOP level below which AKI hospitalization risk is markedly elevated.

Selenium deficiency has been previously associated with increased cardiovascular mortality and poor prognosis in both heart failure and kidney disease.

• Serum Se < 70 µg/L is defined as selenium deficiency in this context.
• SELENOP is described as the main Se transporter and reflects bioavailable Se.
• The prognostic role of SELENOP for SGHS and kidney-related hospitalization in HF was previously unclear prior to this study.