Micronutrient and amino acid losses in acute renal replacement therapy

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

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: https://nottingham-repository.worktribe.com/output/981378
• Publisher URL: https://journals.lww.com/co-clinicalnutrition/Abstract/2015/11000/Micronutrient_and_amino_acid_losses_in_acute_renal.12.aspx
• 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.