Treatment dose and the elimination rates of electrolytes, vitamins, and trace elements during continuous veno-venous hemodialysis (CVVHD)

Abstract

Clinically relevant loss of folic acid, vitamin B12, zinc, inorganic phosphate, and magnesium was not observed for differently used dialysis doses of CVVHD, and the loss was covered sufficiently by daily recommended nutritional supplementation. Increased loss of ionized calcium for higher dialysis doses occurred during citrate CVVHD. Therefore, a strict protocol must maintain calcium homeostasis to avoid calcium depletion.

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

“…The same group reported the depletion effect of CRRT on Cu and Se during a case of prolonged CRRT confirming, resulting in life-threatening complications [ 13 ]. In their first study, Datzmann et al [ 14 ] detected zinc, but no copper, but could not find significant Zn losses in their second study [ 15 ]. Pasko et al detected Cu, Se, Mn Se and Zn in effluent of children undergoing RRT (Table 1 ).…”

“…The most recent showed losses of vitamin C [ 9 ▪▪ , 19 ▪▪ ] but B1, B6, B12, D2, D3 could not be detected [ 19 ▪▪ ]. Searching for vitamins A, B9, B12 and E, Datzmann et al could not detect any in effluent fluid [ 14 , 15 ]. Similarly, Story et al found that vitamin C was detectable in the effluent, but vitamin E was not (Table 1 ).…”

Acute Kidney Injury Incidence in Hospitalized Patients and Implications for Nutrition Support

“…[98][99][100][101][102] In one study of patients undergoing CVVHD, different dialysis doses did not result in clinically relevant losses of folic acid, vitamin B 12 , zinc, magnesium, and inorganic phosphate. 100 This study specifically involved CVVHD and not other types of CRRT, so this may not be generalizable across all CRRT modalities. In another study of critically ill patients undergoing CVVH, serum micronutrient levels of zinc, selenium, and copper did not correlate with hospital length of stay, ICU stay, or time undergoing CVVH.…”

“…99,100 Multiple studies have documented the loss of micronutrients, such as copper, zinc, selenium, folic acid, magnesium, vitamin C, vitamin E, thiamin, chromium, and iron. [98][99][100][101][102] In one study of patients undergoing CVVHD, different dialysis doses did not result in clinically relevant losses of folic acid, vitamin B 12 , zinc, magnesium, and inorganic phosphate. 100 This study specifically involved CVVHD and not other types of CRRT, so this may not be generalizable across all CRRT modalities.…”

“…In addition to the loss of amino acids, patients undergoing RRT also lose micronutrients and vitamins in the RRT effluent 99,100 . Multiple studies have documented the loss of micronutrients, such as copper, zinc, selenium, folic acid, magnesium, vitamin C, vitamin E, thiamin, chromium, and iron 98–102 . In one study of patients undergoing CVVHD, different dialysis doses did not result in clinically relevant losses of folic acid, vitamin B 12 , zinc, magnesium, and inorganic phosphate 100 .…”