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Nutrients and micronutrients at risk during renal replacement therapy : a scoping review

Berger, Mette M. ; Broman, Marcus LU ; Forni, Lui ; Ostermann, Marlies ; De Waele, Elisabeth and Wischmeyer, Paul E. (2021) In Current Opinion in Critical Care 27(4). p.367-377
Abstract

PURPOSE OF REVIEW: Malnutrition is frequent in patients with acute kidney injury. Nutrient clearance during renal replacement therapy (RRT) potentially contributes to this complication. Although losses of amino acid, trace elements and vitamins have been described, there is no clear guidance regarding the role of micronutrient supplementation. RECENT FINDINGS: A scoping review was conducted with the aim to review the existing literature on micronutrients status during RRT: 35 publications including data on effluent losses and blood concentrations were considered relevant and analysed. For completeness, we also included data on amino acids. Among trace elements, negative balances have been shown for copper and selenium: low blood levels... (More)

PURPOSE OF REVIEW: Malnutrition is frequent in patients with acute kidney injury. Nutrient clearance during renal replacement therapy (RRT) potentially contributes to this complication. Although losses of amino acid, trace elements and vitamins have been described, there is no clear guidance regarding the role of micronutrient supplementation. RECENT FINDINGS: A scoping review was conducted with the aim to review the existing literature on micronutrients status during RRT: 35 publications including data on effluent losses and blood concentrations were considered relevant and analysed. For completeness, we also included data on amino acids. Among trace elements, negative balances have been shown for copper and selenium: low blood levels seem to indicate potential deficiency. Smaller size water soluble vitamins were found in the effluent, but not larger size liposoluble vitamins. Low blood values were frequently reported for thiamine, folate and vitamin C, as well as for carnitine. All amino acids were detectable in effluent fluid. Duration of RRT was associated with decreasing blood values. SUMMARY: Losses of several micronutrients and amino acids associated with low blood levels represent a real risk of deficiency for vitamins B1 and C, copper and selenium: they should be monitored in prolonged RRT. Further Research is urgently required as the data are insufficient to generate strong conclusions and prescription recommendations for clinical practice.

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author
; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
subject
in
Current Opinion in Critical Care
volume
27
issue
4
pages
11 pages
publisher
Wolters Kluwer
external identifiers
  • scopus:85111788930
  • pmid:34039873
ISSN
1531-7072
DOI
10.1097/MCC.0000000000000851
language
English
LU publication?
no
id
25a86083-2508-4a7b-b9ce-a371736e96aa
date added to LUP
2021-08-26 14:46:13
date last changed
2024-06-15 15:08:27
@article{25a86083-2508-4a7b-b9ce-a371736e96aa,
  abstract     = {{<p>PURPOSE OF REVIEW: Malnutrition is frequent in patients with acute kidney injury. Nutrient clearance during renal replacement therapy (RRT) potentially contributes to this complication. Although losses of amino acid, trace elements and vitamins have been described, there is no clear guidance regarding the role of micronutrient supplementation. RECENT FINDINGS: A scoping review was conducted with the aim to review the existing literature on micronutrients status during RRT: 35 publications including data on effluent losses and blood concentrations were considered relevant and analysed. For completeness, we also included data on amino acids. Among trace elements, negative balances have been shown for copper and selenium: low blood levels seem to indicate potential deficiency. Smaller size water soluble vitamins were found in the effluent, but not larger size liposoluble vitamins. Low blood values were frequently reported for thiamine, folate and vitamin C, as well as for carnitine. All amino acids were detectable in effluent fluid. Duration of RRT was associated with decreasing blood values. SUMMARY: Losses of several micronutrients and amino acids associated with low blood levels represent a real risk of deficiency for vitamins B1 and C, copper and selenium: they should be monitored in prolonged RRT. Further Research is urgently required as the data are insufficient to generate strong conclusions and prescription recommendations for clinical practice.</p>}},
  author       = {{Berger, Mette M. and Broman, Marcus and Forni, Lui and Ostermann, Marlies and De Waele, Elisabeth and Wischmeyer, Paul E.}},
  issn         = {{1531-7072}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{367--377}},
  publisher    = {{Wolters Kluwer}},
  series       = {{Current Opinion in Critical Care}},
  title        = {{Nutrients and micronutrients at risk during renal replacement therapy : a scoping review}},
  url          = {{http://dx.doi.org/10.1097/MCC.0000000000000851}},
  doi          = {{10.1097/MCC.0000000000000851}},
  volume       = {{27}},
  year         = {{2021}},
}