Micronutrient Alterations During Continuous Renal Replacement Therapy in Critically Ill Adults: A Retrospective Study

Kamel, Amir; Davé, Nisha; Zhao, Vivian; Griffith, Daniel; Connor, Michael; Ziegler, Thomas R.

doi:10.1177/0884533617716618

Cited by 54 publications

(52 citation statements)

References 43 publications

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“…Critically ill patients with acute kidney injury (AKI) are at risk of malnutrition due to several factors, including pre-existing malnourishment, chronic comorbidities, poor nutritional intake, uraemia and the effects of critical illness in general [1][2][3][4] . In patients treated with renal replacement therapy (RRT), unrecognised losses of nutrients may also contribute [5][6][7][8][9][10][11][12][13] . The exact degree of nutrient loss during modern RRT is unknown since most data stem from a few small studies with relatively short periods of RRT (i.e.…”

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confidence: 99%

Micronutrients in critically ill patients with severe acute kidney injury – a prospective study

Ostermann

Summers

Lei

et al. 2020

Sci Rep

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Malnutrition is common in patients with acute kidney injury (AKi) and the risk of mortality is high, especially if renal replacement therapy is needed. Between April 2013 through April 2014, we recruited critically ill adult patients (≥18 years) with severe AKI in two University hospitals in London, UK, and measured serial plasma concentrations of vitamin B 1 , B 6 , B 12 , c and D, folate, selenium, zinc, copper, iron, carnitine and 22 amino acids for six consecutive days. In patients receiving continuous renal replacement therapy (CRRT), the concentrations of the same nutrients in the effluent were also determined. cRRt patients (n = 31) had lower plasma concentrations of citrulline, glutamic acid and carnitine at 24 hrs after enrolment and significantly lower plasma glutamic acid concentrations (74.4 versus 98.2 μmol/L) at day 6 compared to non-CRRT patients (n = 24). All amino acids, trace elements, vitamin C and folate were detectable in effluent fluid. In >30% of CRRT and non-CRRT patients, the plasma nutrient concentrations of zinc, iron, selenium, vitamin D 3 , vitamin c, trytophan, taurine, histidine and hydroxyproline were below the reference range throughout the 6-day period. In conclusion, altered micronutrient status is common in patients with severe AKi regardless of treatment with cRRt.

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confidence: 99%

Micronutrients in critically ill patients with severe acute kidney injury – a prospective study

Ostermann

Summers

Lei

et al. 2020

Sci Rep

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“…116 r For acute renal failure requiring CRRT, an additional daily IV multi-TE supplement such as used for PN is recommended. 117…”

Section: Zincmentioning

confidence: 99%

Parenteral Provision of Micronutrients to Adult Patients: An Expert Consensus Paper

Blaauw

Osland

Sriram

et al. 2019

J Parenter Enteral Nutr

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Background Micronutrients, an umbrella term used to collectively describe vitamins and trace elements, are essential components of nutrition. Those requiring alternative forms of nutrition support are dependent on the prescribed nutrition regimen for their micronutrient provision. The purpose of this paper is to assist clinicians to bridge the gap between the available guidelines’ recommendations and their practical application in the provision of micronutrients via the parenteral route to adult patients. Methods Based on the available evidenced‐based literature and existing guidelines, a panel of multidisciplinary healthcare professionals with significant experience in the provision of parenteral nutrition (PN) and intravenous micronutrients developed this international consensus paper. Results The paper addresses 14 clinically relevant questions regarding the importance and use of micronutrients in various clinical conditions. Practical orientation on how micronutrients should be prescribed, administered, and monitored is provided. Conclusion Micronutrients are a critical component to nutrition provision and PN provided without them pose a considerable risk to nutrition status. Obstacles to their daily provision—including voluntary omission, partial provision, and supply issues—must be overcome to allow safe and responsible nutrition practice.

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“…Patients with oliguric and anuric AKI usually require sodium and potassium restriction. Children undergoing any form of RRT should receive supplemental water soluble vitamins above the recommended dietary allowances 22 .…”

Section: Managementmentioning

confidence: 99%

Management of acute kidney injury in children

Ranawaka

Dayasiri

Gamage

et al. 2019

Sri Lanka J Child Health

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Micronutrient Alterations During Continuous Renal Replacement Therapy in Critically Ill Adults: A Retrospective Study

Cited by 54 publications

References 43 publications

Micronutrients in critically ill patients with severe acute kidney injury – a prospective study

Micronutrients in critically ill patients with severe acute kidney injury – a prospective study

Parenteral Provision of Micronutrients to Adult Patients: An Expert Consensus Paper

Management of acute kidney injury in children

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