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Clinicians should monitor for gastrointestinal intolerance (particularly with oxide or chloride salts) and the risk of hypermagnesemiaparticularly in patients with chronic kidney disease ( 5 Selenium 5.1 Mechanisms of action and biological functions Selenium is a trace element incorporated into selenoproteins (e.g., glutathione peroxidases, thioredoxin reductases) that maintain redox homeostasis and mitigate oxidative damage ( 5.2 Deficiency states and historical perspective The pivotal role of selenium in cardiovascular integrity is historically underscored by its ability to prevent Keshan disease, a once-endemic dilated cardiomyopathy in parts of China with profoundly selenium-deficient soil ( 5.3 Clinical evidence and status-dependent effects Recent data support a U- or L-shaped association between selenium status and cardiorenal outcomes