Protective effects of selenium and vitamin E supplementation on eryptosis, oxidative stress, and inflammation in end-stage renal disease patients.

End-stage renal disease (ESRD) involves chronic microinflammation, oxidative stress, and increased red blood cell (RBC) destruction. This study examined their effects on erythrocyte integrity and oxidative stress in ESRD patients. Seventy ESRD patients were enrolled and received selenium (200 µg) and vitamin E (400 units) supplementation for 60 days. Phosphatidylserine exposure on RBCs was assessed to evaluate eryptosis. Serum levels of malondialdehyde (MDA), glutathione peroxidase (GPx) activity, ferritin, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and iron (Fe) were measured. Statistical analyses were performed using a paired t-test or Wilcoxon signed-rank tests, as appropriate. The findings demonstrated that supplementation was associated with reductions in serum MDA (95% CI 0.89 to 1.05; P < 0.001), ferritin (95% CI 146.58 to 292.01; P < 0.001), IL-6 (95% CI 4.09 to 5.58; P < 0.001), and TNF-α levels (95% CI 9.20 to 10.64; P < 0.001), while increasing GPx activity (95% CI -5.04 to -3.86; P < 0.001). Numerical improvements were noted in RBC count, hemoglobin concentration, erythrocyte stability, and annexin V-positive erythrocytes; however, these changes were not statistically significant and should be considered exploratory. The results indicated that the tested supplements may reduce oxidative stress and inflammation in ESRD patients; however, the erythrocyte-related observations are preliminary and require validation in controlled studies.