Trace Metal Abnormalities in Adults During Hyperalimentation

McClain, Craig J.

doi:10.1177/0148607181005005424

Cited by 25 publications

(2 citation statements)

References 49 publications

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“…However, this resolved with zinc supplementation, documenting how zinc deficiency can cause mental disturbances. From McClain et al 20 and McClain 21 …”

Section: Clinical Manifestations Of Zinc Deficiencymentioning

confidence: 99%

Zinc and Liver Disease

et al. 2012

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Zinc is an essential trace element required for normal cell growth, development, and differentiation. It is involved in DNA synthesis, RNA transcription, and cell division and activation. It is a critical component in many zinc protein/ enzymes, including critical zinc transcription factors. Zinc deficiency/altered metabolism is observed in many types of liver disease, including alcoholic liver disease (ALD) and viral liver disease. Some of the mechanisms for zinc deficiency/ altered metabolism include decreased dietary intake, increased urinary excretion, activation of certain zinc transporters, and induction of hepatic metallothionein. Zinc deficiency may manifest itself in many ways in liver disease, including skin lesions, poor wound healing/liver regeneration, altered mental status, or altered immune function. Zinc supplementation has been documented to block/attenuate experimental ALD through multiple processes, including stabilization of gut-barrier function, decreasing endotoxemia, decreasing proinflammatory cytokine production, decreasing oxidative stress, and attenuating apoptotic hepatocyte death. Clinical trials in human liver disease are limited in size and quality, but it is clear that zinc supplementation reverses clinical signs of zinc deficiency in patients with liver disease. Some studies suggest improvement in liver function in both ALD and hepatitis C following zinc supplementation, and 1 study suggested improved fibrosis markers in hepatitis C patients. The dose of zinc used for treatment of liver disease is usually 50 mg of elemental zinc taken with a meal to decrease the potential side effect of nausea.

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“…However, this resolved with zinc supplementation, documenting how zinc deficiency can cause mental disturbances. From McClain et al 20 and McClain 21 …”

Section: Clinical Manifestations Of Zinc Deficiencymentioning

confidence: 99%

Zinc and Liver Disease

et al. 2012

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“…However, trace element requirements vary with the patient's nutritional and underlying clinical conditions, where additions or restrictions to the normal trace element intake are required. For instance, zinc and selenium requirements are increased in patients with diarrhea and malabsorption syndromes, due to increased gastrointestinal losses [10]. Copper and manganese restriction is indicated in patients with severe cholestasis, due to their reduced biliary excretion [11].…”

Section: Introductionmentioning

confidence: 99%

Continuous venovenous hemodiafiltration trace element clearance in pediatric patients: a case series

et al. 2009

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Continuous renal replacement therapy (CRRT) is used to treat critically ill children with acute kidney injury. The effect of CRRT on trace element clearance is poorly characterized. The purpose of this study was to quantify the transmembrane clearance of chromium, copper, manganese, selenium and zinc during continuous venovenous hemodiafiltration (CVVHDF). The transmembrane clearance of trace elements was assessed prospectively in five critically ill children receiving CVVHDF at the pediatric intensive care unit of a tertiary care university hospital. Pre-filter blood and effluent samples were measured for trace element concentrations. Transmembrane clearance of trace elements was calculated, and daily loss of each trace element was determined. Daily trace element loss via CVVHDF was compared with daily standard supplementation of trace elements in pediatric parenteral nutrition. Five patients (age range 23 months to 15 years) with a body weight range of 10.5-53 kg completed the study. The median transmembrane clearance of chromium, copper, manganese, selenium and zinc during CVVHDF was calculated as 0 ml, 0.59 ml, 2.48 ml, 1.22 ml, and 1.90 ml, respectively, per 1.73 m(2) body surface area per minute. The calculated CVVHDF losses were substantially smaller than the daily parenteral supplementation for all trace elements.

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