Login to MyKarger

New to MyKarger? Click here to sign up.



Login with Facebook

Forgot your password?

Authors, Editors, Reviewers

For Manuscript Submission, Check or Review Login please go to Submission Websites List.

Submission Websites List

Institutional Login
(Shibboleth or Open Athens)

For the academic login, please select your country in the dropdown list. You will be redirected to verify your credentials.

Original Paper

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

Datzmann T. · Träger K. · Reinelt H. · von Freyberg P.

Author affiliations

Department of Cardiac Anesthesiology, University Hospital Ulm, Ulm, Germany

Related Articles for ""

Blood Purif 2017;44:210-216

Do you have an account?

Login Information





Contact Information










I have read the Karger Terms and Conditions and agree.



Login Information





Contact Information










I have read the Karger Terms and Conditions and agree.



To view the fulltext, please log in

To view the pdf, please log in

Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.


Save over 20% compared to the individual article price.
Learn more

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restrictions apply

Rental: USD 8.50
Cloud: USD 20.00


Select

Subscribe

  • Access to all articles of the subscribed year(s) guaranteed for 5 years
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates


Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: February 07, 2017
Accepted: May 12, 2017
Published online: August 09, 2017
Issue release date: October 2017

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 4

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU

Abstract

Background/Aims: During continuous renal replacement therapy, relevant losses of nutritional substrates, vitamins, and trace elements via the filter may occur. We investigated filter lifetime efficiency during a 72-h treatment period. Methods: This prospective study included 40 patients undergoing citrate continuous veno-venous hemodialysis (CVVHD). The elimination rates were measured at 24, 48, and 72 h. To assess the influence of filter lifetime, we determined substrate loss every 24 h over a 72-h interval. Results: Filter lifetime did not affect the loss of ionized calcium, inorganic phosphate, magnesium, zinc, folic acid, and vitamin B12. Nevertheless, we did observe clinically significant loss of ionized calcium and inorganic phosphate during CVVHD that required supplementation. Conclusions: CVVHD leads to significant loss of ionized calcium and inorganic phosphate that is independent of the filter lifetime.

© 2017 S. Karger AG, Basel


References

  1. Amanzadeh J, Reilly RF Jr: Hypophosphatemia: an evidence-based approach to its clinical consequences and management. Nat Clin Pract Nephrol 2006;2:136-148.
  2. Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P: Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 2004;8:R204-R212.
  3. Ronco C, Bellomo R: Dialysis in intensive care unit patients with acute kidney injury: continuous therapy is superior. Clin J Am Soc Nephrol 2007;2:597-600.
  4. Mehta RL, McDonald BR, Aguilar MM, Ward DM: Regional citrate anticoagulation for continuous arteriovenous hemodialysis in critically ill patients. Kidney Int 1990;38:976-981.
  5. Morgera S, Schneider M, Slowinski T, Vargas-Hein O, Zuckermann-Becker H, Peters H, Kindgen-Milles D, Neumayer HH: A safe citrate anticoagulation protocol with variable treatment efficacy and excellent control of the acid-base status. Crit Care Med 2009;37:2018-2024.
  6. Palsson R, Niles JL: Regional citrate anticoagulation in continuous venovenous hemofiltration in critically ill patients with a high risk of bleeding. Kidney Int 1999;55:1991-1997.
  7. Liu C, Mao Z, Kang H, Hu J, Zhou F: Regional citrate versus heparin anticoagulation for continuous renal replacement therapy in critically ill patients: a meta-analysis with trial sequential analysis of randomized controlled trials. Crit Care 2016;20:144.
  8. Connor MJ, Salem C, Bauer SR, Hofmann CL, Groszek J, Butler R, Rehm SJ, Fissell WH: Therapeutic drug monitoring of piperacillin-tazobactam using spent dialysate effluent in patients receiving continuous venovenous hemodialysis. Antimicrob Agents Chemother 2011;55:557-560.
  9. Berger MM, Shenkin A, Revelly JP, Roberts E, Cayeux MC, Baines M, Chiolero RL: Copper, selenium, zinc, and thiamine balances during continuous venovenous hemodiafiltration in critically ill patients. Am J Clin Nutr 2004;80:410-416.
    External Resources
  10. Churchwell MD, Pasko DA, Btaiche IF, Jain JC, Mueller BA: Trace element removal during in vitro and in vivo continuous haemodialysis. Nephrol Dial Transplant 2007;22:2970-2977.
  11. Pasko DA, Churchwell MD, Btaiche IF, Jain JC, Mueller BA: Continuous venovenous hemodiafiltration trace element clearance in pediatric patients: a case series. Pediatr Nephrol 2009;24:807-813.
  12. Section 2: AKI definition. Kidney Int Suppl 2012;2:19-36.
  13. Biesalski HK, Bischoff SC, Boehles HJ, Muehlhoefer A: Water, electrolytes, vitamins and trace elements - Guidelines on Parenteral Nutrition, Chapter 7. German Ger Med Sci 2009;7:Doc21.
  14. Ronco C, Bellomo R, Homel P, Brendolan A, Dan M, Piccinni P, La Greca G: Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure: a prospective randomised trial. Lancet 2000;356:26-30.
  15. Ricci Z, Ronco C, Bachetoni A, D'amico G, Rossi S, Alessandri E, Rocco M, Pietropaoli P: Solute removal during continuous renal replacement therapy in critically ill patients: convection versus diffusion. Crit Care 2006;10:R67.
  16. Bagshaw SM, George C, Dinu I, Bellomo R: A multi-centre evaluation of the RIFLE criteria for early acute kidney injury in critically ill patients. Nephrol Dial Transplant 2008;23:1203-1210.
  17. Tolwani AJ, Campbell RC, Stofan BS, Lai KR, Oster RA, Wille KM: Standard versus high-dose CVVHDF for ICU-related acute renal failure. J Am Soc Nephrol 2008;19:1233-1238.
  18. Saudan P, Niederberger M, Seigneux S De, Romand J, Pugin J, Perneger T, Martin PY: Adding a dialysis dose to continuous hemofiltration increases survival in patients with acute renal failure. Kidney Int 2006;70:1312-1317.
  19. Uchino S, Bellomo R, Morimatsu H, Morgera S, Schetz M, Tan I, Bouman C, Macedo E, Gibney N, Tolwani A, Oudemans-van Straaten H, Ronco C, Kellum JA: Continuous renal replacement therapy: a worldwide practice survey. The beginning and ending supportive therapy for the kidney (B.E.S.T. kidney) investigators. Intensive Care Med 2007;33:1563-1570.
  20. Medve L, Antek C, Paloczi B, Kocsi S, Gartner B, Marjanek Z, Bencsik G, Kanizsai P, Gondos T: Epidemiology of acute kidney injury in Hungarian intensive care units: a multicenter, prospective, observational study. BMC Nephrol 2011;12:43.
  21. Uchino S, Kellum JA, Bellomo R, Doig GS, Morimatsu H, Morgera S, Schetz M, Tan I, Bouman C, Macedo E, Gibney N, Tolwani A, Ronco C: Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA 2005;294:813-818.
  22. Klein CJ, Moser-Veillon PB, Schweitzer A, Douglass LW, Reynolds HN, Patterson KY, Veillon C: Magnesium, calcium, zinc, and nitrogen loss in trauma patients during continuous renal replacement therapy. JPEN J Parenter Enteral Nutr 2002;26:77-92; discussion 92-93.
  23. Brain M, Parkes S, Fowler P, Robertson I, Brown A: Calcium flux in continuous venovenous haemodiafiltration with heparin and citrate anticoagulation. Crit Care Resusc 2011;13:72-81.
    External Resources
  24. RENAL Replacement Therapy Study Investigators, Bellomo R, Cass A, Cole L, Finfer S, Gallagher M, Lo S, McArthur C, McGuinness S, Myburgh J, Norton R, Scheinkestel C, Su S: Intensity of continuous renal-replacement therapy in critically ill patients. N Engl J Med 2009;361:1627-1638.
  25. Druml W: Metabolic aspects of continuous renal replacement therapies. Kidney Int Suppl 1999:S56-S61.
  26. Tan HK, Uchino S, Bellomo R: Electrolyte mass balance during CVVH: lactate vs. bicarbonate-buffered replacement fluids. Ren Fail 2004;26:149-153.
  27. Morgera S, Haase M, Ruckert M, Krieg H, Kastrup M, Krausch D, Vargas-Hein O, Zuckermann-Becker H, Peters H, Pohlmeier R, Neumayer HH: Regional citrate anticoagulation in continuous hemodialysis-acid-base and electrolyte balance at an increased dose of dialysis. Nephron Clin Pract 2005;101:c211-c219.
  28. Tonelli M, Wiebe N, Hemmelgarn B, Klarenbach S, Field C, Manns B, Thadhani R, Gill J: Trace elements in hemodialysis patients: a systematic review and meta-analysis. BMC Med 2009;7:25.
  29. Singer P, Berger MM, van den Berghe G, Biolo G, Calder P, Forbes A, Griffiths R, Kreyman G, Leverve X, Pichard C, ESPEN: ESPEN Guidelines on Parenteral Nutrition: intensive care. Clin Nutr 2009;28:387-400.
  30. Besecker BY, Exline MC, Hollyfield J, Phillips G, Disilvestro RA, Wewers MD, Knoell DL: A comparison of zinc metabolism, inflammation, and disease severity in critically ill infected and noninfected adults early after intensive care unit admission. Am J Clin Nutr 2011;93:1356-1364.
  31. Fortin MC, Amyot SL, Geadah D, Leblanc M: Serum concentrations and clearances of folic acid and pyridoxal-5-phosphate during venovenous continuous renal replacement therapy. Intensive Care Med 1999;25:594-598.
  32. Zappitelli M, Juarez M, Castillo L, Coss-Bu J, Goldstein SL: Continuous renal replacement therapy amino acid, trace metal and folate clearance in critically ill children. Intensive Care Med 2009;35:698-706.
  33. Maursetter L, Kight CE, Mennig J, Hofmann RM: Review of the mechanism and nutrition recommendations for patients undergoing continuous renal replacement therapy. Nutr Clin Pract 2011;26:382-390.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: February 07, 2017
Accepted: May 12, 2017
Published online: August 09, 2017
Issue release date: October 2017

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 4

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.