Prevention of hypomagnesemia in critically ill patients with acute kidney injury on continuous kidney replacement therapy: the role of early supplementation and close monitoring

Mario, Francesca Di; Regolisti, Giuseppe; Greco, Paolo; Maccari, Clara; Superchi, Eleonora; Morabito, Santo; Pistolesi, Valentina; Fiaccadori, Enrico

doi:10.1007/s40620-020-00864-4

Cited by 24 publications

(9 citation statements)

References 64 publications

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“…Finally, hypomagnesemia, generally defined as serum magnesium levels <0.70 mmol/l and commonly classified as mild, moderate, and severe (respectively between 0.76 and 0.64, between 0.63 and 0.40 and <0.40 mmol/l), has been reported in up to 12% of hospitalized patients with an incidence around 60e65% among critically ill patients [252,253]. In addition to the most common causes (such as diarrhea, malabsorption syndrome, chronic use of proton pump inhibitors and diuretics, hypercalcemia, and volume expansion), increased attention has recently been directed to the increased magnesium removal in course of KRT [254]. In particular, the onset and the exacerbation of hypomagnesemia in course of CKRT have been associated not only to the depurative mechanism at the basis of dialysis treatment (diffusive or convective clearance) but also to the amount of ionized magnesium chelated by citrate when regional citrate anticoagulation is utilized and magnesium is lost in the effluent under the form of magnesiumecitrate complexes [246,255e258].…”

Section: Would Adding Glutamine Supplements Lead To Improved Outcomes?mentioning

confidence: 99%

ESPEN guideline on clinical nutrition in hospitalized patients with acute or chronic kidney disease

et al. 2021

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Acute kidney disease (AKD) -which includes acute kidney injury (AKI) e and chronic kidney disease (CKD) are highly prevalent among hospitalized patients, including those in nephrology and medicine wards, surgical wards, and intensive care units (ICU), and they have important metabolic and nutritional consequences.Moreover, in case kidney replacement therapy (KRT) is started, whatever is the modality used, the possible impact on nutritional profiles, substrate balance, and nutritional treatment processes cannot be neglected.The present guideline is aimed at providing evidence-based recommendations for clinical nutrition in hospitalized patients with AKD and CKD. Due to the significant heterogeneity of this patient population as well as the paucity of high-quality evidence data, the present guideline is to be intended as a basic framework of both evidence and -in most cases -expert opinions, aggregated in a structured consensus process, in order to update the two previous ESPEN Guidelines on Enteral (2006) and Parenteral (2009) Nutrition in Adult Renal Failure. Nutritional care for patients with stable CKD (i.e., controlled protein content diets/low protein diets with or without amino acid/ketoanalogue integration in outpatients up to CKD stages four and five), nutrition in kidney transplantation, and pediatric kidney disease will not be addressed in the present guideline.

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Section: Would Adding Glutamine Supplements Lead To Improved Outcomes?mentioning

confidence: 99%

ESPEN guideline on clinical nutrition in hospitalized patients with acute or chronic kidney disease

et al. 2021

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“…Due to decreased excretion, magnesium levels classically increase in AKI, though many critically ill patients develop hypomagnesemia [136][137][138]. Hence, the nutritional delivery of magnesium is adjusted based on serum levels.…”

Section: Carnitinementioning

confidence: 99%

Nutritional management of children with acute kidney injury—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce

et al. 2023

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The nutritional management of children with acute kidney injury (AKI) is complex. The dynamic nature of AKI necessitates frequent nutritional assessments and adjustments in management. Dietitians providing medical nutrition therapies to this patient population must consider the interaction of medical treatments and AKI status to effectively support both the nutrition status of patients with AKI as well as limit adverse metabolic derangements associated with inappropriately prescribed nutrition support. The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric renal dietitians and pediatric nephrologists, has developed clinical practice recommendations (CPR) for the nutritional management of children with AKI. We address the need for intensive collaboration between dietitians and physicians so that nutritional management is optimized in line with AKI medical treatments. We focus on key challenges faced by dietitians regarding nutrition assessment. Furthermore, we address how nutrition support should be provided to children with AKI while taking into account the effect of various medical treatment modalities of AKI on nutritional needs. Given the poor quality of evidence available, a Delphi survey was conducted to seek consensus from international experts. Statements with a low grade or those that are opinion-based must be carefully considered and adapted to individual patient needs, based on the clinical judgment of the treating physician and dietitian. Research recommendations are provided. CPRs will be regularly audited and updated by the PRNT.

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“…Magnesium spielt eine wichtige Rolle bei der Kontrolle der Herzfrequenz, der Muskelkontraktion und -relaxation, der nervalen Reizübermittlung und des vaskulären Tonus. Aus diesem Grund sollte auch eine Hypomagnesiämie korrigiert werden [ 15 ]. Eine Hypomagnesiämie kann auch im Zusammenhang mit einem Refeedingsyndrom auftreten und insbesondere einen paralytischen Ileus bzw.…”

Section: Laborchemisches Monitoring Der Mntunclassified

Laborchemisches und kalorimetrisches Monitoring der medizinischen Ernährungstherapie auf der Intensiv- und Intermediate Care Station

Elke

Hartl

Adolph

et al. 2023

Med Klin Intensivmed Notfmed

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ZusammenfassungDieses zweite Positionspapier der Sektion Metabolismus und Ernährung der Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin (DIVI) gibt Empfehlungen zum laborchemischen Monitoring der Makro- und Mikronährstoffzufuhr sowie zum Einsatz der indirekten Kalorimetrie im Rahmen der medizinischen Ernährungstherapie erwachsener Intensivpatient:innen. Zusätzlich werden Empfehlungen zur krankheitsbezogenen bzw. individuellen (Spiegelbestimmung) Substitution und (Hochdosis‑)Pharmakotherapie von Vitaminen und Spurenelementen vorgenommen.

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Prevention of hypomagnesemia in critically ill patients with acute kidney injury on continuous kidney replacement therapy: the role of early supplementation and close monitoring

Cited by 24 publications

References 64 publications

ESPEN guideline on clinical nutrition in hospitalized patients with acute or chronic kidney disease

ESPEN guideline on clinical nutrition in hospitalized patients with acute or chronic kidney disease

Nutritional management of children with acute kidney injury—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce

Laborchemisches und kalorimetrisches Monitoring der medizinischen Ernährungstherapie auf der Intensiv- und Intermediate Care Station

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