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Micronutrient and amino acid losses in acute renal replacement therapy

Oh, Weng C.; Gardner, David S.; Devonald, Mark A.J.

Authors

Weng C. Oh

Mark A.J. Devonald



Abstract

A wide range of renal replacement therapies is now available to support patients with acute kidney injury. These treatments utilize diffusion, convection or a combination of these mechanisms to remove metabolic waste products from the bloodstream. It is inevitable that physiologically important substances including micronutrients will also be removed. Here we review current knowledge of the extent of micronutrient loss, how it varies between treatment modalities and its clinical significance.
Recent findings
Very few studies have specifically investigated micronutrient loss in renal replacement therapy for acute kidney injury. Recent data suggest that trace elements and amino acids are lost during intermittent dialysis, hybrid therapies such as sustained low efficiency diafiltration and continuous therapies. Extent of micronutrient loss appears to vary with treatment type, with continuous convection based treatments probably causing greatest losses.
Summary
Patients with acute kidney injury are at high risk of disease related malnutrition. The use of renal replacement therapy, while often essential for life support, results in loss of micronutrients into the filtrate or dialysate. Losses are probably greater with continuous convective treatments, but it is not yet known whether these losses are clinically significant or whether their replacement would improve patient outcomes.

Citation

Oh, W. C., Gardner, D. S., & Devonald, M. A. (2015). Micronutrient and amino acid losses in acute renal replacement therapy. Current Opinion in Clinical Nutrition and Metabolic Care, 18(6), 593-598. https://doi.org/10.1097/MCO.0000000000000220

Journal Article Type Article
Acceptance Date Nov 1, 2015
Online Publication Date Nov 1, 2015
Publication Date Nov 1, 2015
Deposit Date Feb 19, 2016
Publicly Available Date Feb 19, 2016
Journal Current Opinion in Clinical Nutrition and Metabolic Care
Print ISSN 1363-1950
Electronic ISSN 1473-6519
Publisher Lippincott, Williams & Wilkins
Peer Reviewed Peer Reviewed
Volume 18
Issue 6
Pages 593-598
DOI https://doi.org/10.1097/MCO.0000000000000220
Keywords acute kidney injury; haemofiltration; micronutrients; renal replacement therapy; sustained low-efficiency diafiltration
Public URL http://eprints.nottingham.ac.uk/id/eprint/31850
Publisher URL https://journals.lww.com/co-clinicalnutrition/Abstract/2015/11000/Micronutrient_and_amino_acid_losses_in_acute_renal.12.aspx
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf
Additional Information This is a non-final version of an article published in final form in: Oh, Weng C., Gardner, David S., Devonald, Mark A.J. 2015 "Micronutrient and amino acid losses in acute renal replacement therapy" Current Opinion in Clinical Nutrition and Metabolic Care, v. 18, issue 6: 593-598.

Files

Revised submitted pdf July 2015.pdf (583 Kb)
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Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





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