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Nutritional effect of continuous hemodiafiltration

D C Frankenfield1, H N Reynolds

  • 1Department of Clinical Nutrition, Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA.

Nutrition (Burbank, Los Angeles County, Calif.)
|July 1, 1995
PubMed
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Continuous hemodiafiltration effectively removes toxins but can lead to significant amino acid loss. Nutrient and vitamin losses require further investigation for optimal patient care during renal replacement therapy.

Area of Science:

  • Nephrology
  • Critical Care Medicine
  • Nutritional Science

Background:

  • Continuous hemodiafiltration (CAVH/CVVH) is a vital renal replacement therapy for critically ill patients with acute renal failure.
  • This therapy efficiently removes fluids and uremic toxins, supporting nutritional interventions.
  • However, the non-selective nature of hemodiafilters poses a risk of nutrient loss alongside toxin clearance.

Purpose of the Study:

  • To evaluate the extent of nutrient loss during continuous hemodiafiltration.
  • To identify which nutrients are most susceptible to loss or absorption during this therapy.
  • To highlight knowledge gaps regarding vitamin and mineral status during continuous hemodiafiltration.

Main Methods:

  • Analysis of nutrient (amino acids, lipids, proteins, glucose) and fluid removal/absorption during continuous hemodiafiltration.

Related Experiment Videos

  • Assessment of dialysate composition (dextrose-free vs. dextrose-containing) and its impact on glucose balance.
  • Identification of research gaps concerning vitamin and mineral losses and requirements.

    • Main Results:

    • Significant amino acid loss occurs, averaging 10-15 g/day, with potential for >30 g/day in some cases.
    • Lipids and intact proteins show minimal loss; glucose loss is minimal with dextrose-free dialysate but absorption can be significant with dextrose-containing solutions.
    • Vitamin and mineral losses and requirements during continuous hemodiafiltration are largely unknown.

    Conclusions:

    • Continuous hemodiafiltration, while effective for toxin removal, necessitates careful monitoring for nutrient losses, particularly amino acids.
    • Dialysate composition significantly impacts glucose balance, requiring tailored approaches.
    • Further research is crucial to understand and manage vitamin and mineral status in patients undergoing continuous hemodiafiltration.