Role of selenium in the pathophysiology of cardiorenal anaemia syndrome

Abstract Chronic kidney disease (CKD) and cardiovascular disease (CVD) have multiple bidirectional mechanisms, and anaemia is one of the critical factors that are associated with the progression of the two disorders [referred to as cardiorenal anaemia syndrome (CRAS)]. Several lines of evidence indi...

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Main Authors: Shigeyuki Arai, Minoru Yasukawa, Shigeru Shibata
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:ESC Heart Failure
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Online Access:https://doi.org/10.1002/ehf2.14893
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author Shigeyuki Arai
Minoru Yasukawa
Shigeru Shibata
author_facet Shigeyuki Arai
Minoru Yasukawa
Shigeru Shibata
author_sort Shigeyuki Arai
collection DOAJ
description Abstract Chronic kidney disease (CKD) and cardiovascular disease (CVD) have multiple bidirectional mechanisms, and anaemia is one of the critical factors that are associated with the progression of the two disorders [referred to as cardiorenal anaemia syndrome (CRAS)]. Several lines of evidence indicate that CRAS confers a worse prognosis, suggesting the need to clarify the underlying pathophysiology. Among the micronutrients (trace elements) that are essential to humans, inadequate iron status has previously been implicated in the pathogenesis of CRAS; however, the roles of other trace elements remain unclear. Selenium critically regulates the function of selenoproteins, in which selenocysteine is present at the active centres. The human genome encodes 25 selenoproteins, and accumulating data indicate that they regulate diverse physiological processes, including cellular redox homeostasis, calcium flux, thyroid hormone activity and haematopoiesis, all of which directly or indirectly influence cardiac function. The essential role of selenium in human health is underscored by the fact that its deficiency results in multiple disorders, among which are cardiomyopathy and abnormal erythrocyte morphology. Studies have shown that selenium deficiency is not uncommon in CKD patients with poor nutritional status, suggesting that it may be an under‐recognized cause of anaemia and cardiovascular disorders in these patients. In this review, we discuss the role of selenium in the pathophysiology of CKD, particularly in the context of the interconnection among CKD, cardiac dysfunction and anaemia. Given that selenium deficiency is associated with treatment‐resistant anaemia and an increased risk of CVD, its role as a key modulator of CRAS merits future investigation.
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spelling doaj-art-e9b309f017fe4a07b5857217b3dc5e162025-08-20T02:55:48ZengWileyESC Heart Failure2055-58222025-04-0112277078010.1002/ehf2.14893Role of selenium in the pathophysiology of cardiorenal anaemia syndromeShigeyuki Arai0Minoru Yasukawa1Shigeru Shibata2Division of Nephrology, Department of Internal Medicine Teikyo University School of Medicine Tokyo JapanDivision of Nephrology, Department of Internal Medicine Teikyo University School of Medicine Tokyo JapanDivision of Nephrology, Department of Internal Medicine Teikyo University School of Medicine Tokyo JapanAbstract Chronic kidney disease (CKD) and cardiovascular disease (CVD) have multiple bidirectional mechanisms, and anaemia is one of the critical factors that are associated with the progression of the two disorders [referred to as cardiorenal anaemia syndrome (CRAS)]. Several lines of evidence indicate that CRAS confers a worse prognosis, suggesting the need to clarify the underlying pathophysiology. Among the micronutrients (trace elements) that are essential to humans, inadequate iron status has previously been implicated in the pathogenesis of CRAS; however, the roles of other trace elements remain unclear. Selenium critically regulates the function of selenoproteins, in which selenocysteine is present at the active centres. The human genome encodes 25 selenoproteins, and accumulating data indicate that they regulate diverse physiological processes, including cellular redox homeostasis, calcium flux, thyroid hormone activity and haematopoiesis, all of which directly or indirectly influence cardiac function. The essential role of selenium in human health is underscored by the fact that its deficiency results in multiple disorders, among which are cardiomyopathy and abnormal erythrocyte morphology. Studies have shown that selenium deficiency is not uncommon in CKD patients with poor nutritional status, suggesting that it may be an under‐recognized cause of anaemia and cardiovascular disorders in these patients. In this review, we discuss the role of selenium in the pathophysiology of CKD, particularly in the context of the interconnection among CKD, cardiac dysfunction and anaemia. Given that selenium deficiency is associated with treatment‐resistant anaemia and an increased risk of CVD, its role as a key modulator of CRAS merits future investigation.https://doi.org/10.1002/ehf2.14893cardiomyopathychronic kidney diseasemicronutrientsselenium deficiencytrace element
spellingShingle Shigeyuki Arai
Minoru Yasukawa
Shigeru Shibata
Role of selenium in the pathophysiology of cardiorenal anaemia syndrome
ESC Heart Failure
cardiomyopathy
chronic kidney disease
micronutrients
selenium deficiency
trace element
title Role of selenium in the pathophysiology of cardiorenal anaemia syndrome
title_full Role of selenium in the pathophysiology of cardiorenal anaemia syndrome
title_fullStr Role of selenium in the pathophysiology of cardiorenal anaemia syndrome
title_full_unstemmed Role of selenium in the pathophysiology of cardiorenal anaemia syndrome
title_short Role of selenium in the pathophysiology of cardiorenal anaemia syndrome
title_sort role of selenium in the pathophysiology of cardiorenal anaemia syndrome
topic cardiomyopathy
chronic kidney disease
micronutrients
selenium deficiency
trace element
url https://doi.org/10.1002/ehf2.14893
work_keys_str_mv AT shigeyukiarai roleofseleniuminthepathophysiologyofcardiorenalanaemiasyndrome
AT minoruyasukawa roleofseleniuminthepathophysiologyofcardiorenalanaemiasyndrome
AT shigerushibata roleofseleniuminthepathophysiologyofcardiorenalanaemiasyndrome