Serum concentrations and clearances of folic acid and pyridoxal-5′-phosphate during venovenous continuous renal replacement therapy

Abstract

Significant losses of folic acid and P-5'-P (and most likely of other hydrosoluble vitamins) occur during CRRT. Considering that stores of most hydrosoluble vitamins are relatively low in critically ill patients, supplementation should be provided to patients treated similarly.

Elimination Rates of Electrolytes, Vitamins, and Trace Elements during Continuous Renal Replacement Therapy with Citrate Continuous Veno-Venous Hemodialysis: Influence of Filter Lifetime

“…Due to the water solubility and a molecular mass of approximately 441 Da, folic acid could be detected in the effluent. Significant folic acid loss occurs by CRRT in adults [31] and children [32]. The median daily loss for folic acid in our study was 268 nmol/L, which is well below the mean daily loss of 650 nmol/L reported by others [31].…”

“…The baseline of folic acid serum concentrations was within the normal range [31]. Due to the water solubility and a molecular mass of approximately 441 Da, folic acid could be detected in the effluent.…”

Dosing Recommendations for Continuous Venovenous Hemodiafiltration with AN69 Filter Membranes and Prismaflex Dialyzers

“…The methods used for studies of glutamine, folic acid, and pyridoxal-5'-phosphate did not allow determination of pharmacokinetic parameters specific to CVVHDF, and these studies were also excluded. 5,6 Therefore, a total of 22 studies of 14 medications were included in the final review (Table 1). For each of the 14 medications, the total clearance and elimination constant (K e ) for healthy patients were extracted (Table 2), as well as the usual dosing for critically ill patients (Table 3).…”

Is Routine Multivitamin Supplementation Necessary in US Chronic Adult Hemodialysis Patients? A Systematic Review

“…If true, part of the explanation may lie in the plasma clearance of vitamin B6 during dialysis, which was reported to be between 28 and 48% depending upon the dialyzer used 35 , with cellulose triacetate high-flux/high-efficiency (HF/HE) dialysis membranes clearing vitamin B6 to a much greater extent than cuprophane membranes 36 . Similarly, continuous renal replacement therapy has been noted to clear PLP by a mean of 0.02 mg/day 35 . However, the assertion that pyridoxine is cleared by hemodialysis has been challenged in a more recent study 37 .…”