Micronutrient and amino acid losses in acute renal replacement therapy

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 subs...

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Main Authors: Oh, Weng C., Gardner, David S., Devonald, Mark A.J.
Format: Article
Published: Lippincot, Williams & Wilkins 2015
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Online Access:https://eprints.nottingham.ac.uk/31850/
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author Oh, Weng C.
Gardner, David S.
Devonald, Mark A.J.
author_facet Oh, Weng C.
Gardner, David S.
Devonald, Mark A.J.
author_sort Oh, Weng C.
building Nottingham Research Data Repository
collection Online Access
description 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.
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spelling nottingham-318502020-05-04T20:06:31Z https://eprints.nottingham.ac.uk/31850/ Micronutrient and amino acid losses in acute renal replacement therapy Oh, Weng C. Gardner, David S. Devonald, Mark A.J. 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. Lippincot, Williams & Wilkins 2015-11 Article PeerReviewed Oh, Weng C., 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 acute kidney injury; haemofiltration; micronutrients; renal replacement therapy; sustained low-efficiency diafiltration https://journals.lww.com/co-clinicalnutrition/Abstract/2015/11000/Micronutrient_and_amino_acid_losses_in_acute_renal.12.aspx doi:10.1097/MCO.0000000000000220 doi:10.1097/MCO.0000000000000220
spellingShingle acute kidney injury; haemofiltration; micronutrients; renal replacement therapy; sustained low-efficiency diafiltration
Oh, Weng C.
Gardner, David S.
Devonald, Mark A.J.
Micronutrient and amino acid losses in acute renal replacement therapy
title Micronutrient and amino acid losses in acute renal replacement therapy
title_full Micronutrient and amino acid losses in acute renal replacement therapy
title_fullStr Micronutrient and amino acid losses in acute renal replacement therapy
title_full_unstemmed Micronutrient and amino acid losses in acute renal replacement therapy
title_short Micronutrient and amino acid losses in acute renal replacement therapy
title_sort micronutrient and amino acid losses in acute renal replacement therapy
topic acute kidney injury; haemofiltration; micronutrients; renal replacement therapy; sustained low-efficiency diafiltration
url https://eprints.nottingham.ac.uk/31850/
https://eprints.nottingham.ac.uk/31850/
https://eprints.nottingham.ac.uk/31850/