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Related Concept Videos

Continuous Renal Replacement Therapy01:30

Continuous Renal Replacement Therapy

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Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
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Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

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Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
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Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

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In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
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Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

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Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
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Renal Drug Excretion: Tubular Reabsorption01:25

Renal Drug Excretion: Tubular Reabsorption

215
Tubular reabsorption, a process occurring post-glomerular filtration of drugs in the renal tubule, is a critical determinant of drug half-life. During the process of renal excretion, as the glomerular filtrate progresses to the distal convoluted tubule (DCT), drugs that are highly permeable, lipophilic, and nonionized undergo passive reabsorption from the tubular fluid into the surrounding peritubular capillaries. This reabsorption process restricts their elimination through the kidneys. This...
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Related Experiment Video

Updated: Jul 18, 2025

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Micronutrient Losses during Continuous Renal Replacement Therapy.

Nuttha Lumlertgul1,2,3, Lynda K Cameron4,5,6, Danielle E Bear4,7

  • 1Division of Nephrology, Excellence Centre for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand, nlumlertgul@gmail.com.

Nephron
|August 23, 2023
PubMed
Summary

Acute kidney injury and renal replacement therapy (RRT) deplete essential micronutrients. Supplementation strategies require further research to determine optimal doses and methods for critically ill patients.

Keywords:
Acute kidney injuryMicronutrientMicronutrient lossRenal replacement therapyTrace elementVitamin

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Area of Science:

  • Nephrology
  • Clinical Nutrition
  • Critical Care Medicine

Background:

  • Acute kidney injury (AKI) disrupts micronutrient balance through impaired absorption, altered metabolism, and increased demand.
  • Renal replacement therapy (RRT) further exacerbates micronutrient depletion via diffusion and adhesion losses.
  • Significant variability exists in reported micronutrient levels and losses among RRT patients.

Purpose of the Study:

  • To review the impact of AKI and RRT on micronutrient status.
  • To identify commonly depleted nutrients in patients undergoing RRT.
  • To highlight the need for further research on micronutrient supplementation in this population.

Main Methods:

  • Literature review of studies investigating micronutrient status in AKI and RRT.
  • Analysis of factors influencing micronutrient levels, including RRT modality, dose, and duration.
  • Identification of frequently reported depleted micronutrients.

Main Results:

  • Water-soluble vitamins, selenium, copper, and carnitine are frequently found to be depleted.
  • Micronutrient losses and plasma concentrations vary significantly based on RRT parameters.
  • Mechanisms include decreased enteral absorption, altered redistribution, metabolism, and consumption.

Conclusions:

  • AKI and RRT significantly affect patient micronutrient status.
  • Optimal strategies for micronutrient supplementation in critically ill RRT patients remain undetermined.
  • Further investigation is needed to establish effective supplementation protocols.