Micronutrient and amino acid losses in acute renal replacement therapy

Oh, Weng C. and Gardner, David S. and Devonald, Mark A.J. (2015) Micronutrient and amino acid losses in acute renal replacement therapy. Current Opinion in Clinical Nutrition and Metabolic Care, 18 (6). pp. 593-598. ISSN 1473-6519

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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.

Item Type: Article
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.
Keywords: acute kidney injury; haemofiltration; micronutrients; renal replacement therapy; sustained low-efficiency diafiltration
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine
University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Veterinary Medicine and Science
Identification Number: doi:00075197-201511000-00012
Depositing User: Gardner, David
Date Deposited: 19 Feb 2016 13:23
Last Modified: 07 Dec 2016 02:00
URI: http://eprints.nottingham.ac.uk/id/eprint/31850

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