Intensive Care Medicine

, Volume 35, Issue 4, pp 698–706 | Cite as

Continuous renal replacement therapy amino acid, trace metal and folate clearance in critically ill children

  • Michael Zappitelli
  • Marisa Juarez
  • L. Castillo
  • Jorge Coss-Bu
  • Stuart L. Goldstein
Pediatric Original



We hypothesized continuous veno-venous hemodialysis (CVVHD) amino acid, trace metals and folate clearance impacts nutrient balance.


Critically ill children receiving CVVHD were studied prospectively for 5 days. Blood concentrations (amino acids, copper, zinc, manganese, chromium, selenium and folate) were measured at CVVHD initiation, and Days 2 and 5. CVVHD clearance, losses and nutrient balances were calculated on Days 2 and 5.


We studied 15 children aged 7.7 ± 6.7 years. Nitrogen balance was negative on Days 2 and 5. Amino acid clearances ranged from 2.8 to 51.1 ml/min per 1.73 m2. CVVHD losses corresponded to 20% of intake. Days 2 and 5 balances were negative for selenium, but positive for other trace metals. Folate clearance was 16 ml/min per 1.73 m2 on Days 2 and 5 and serum concentrations decreased significantly from initiation to Day 5 (P < 0.05).


Nutrient losses by CVHHD may impact adequate nutrition provision.


Continuous veno-venous hemodialysis Pediatric Intensive care Nutrition Protein Vitamins 


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Michael Zappitelli
    • 1
  • Marisa Juarez
    • 2
  • L. Castillo
    • 3
  • Jorge Coss-Bu
    • 3
  • Stuart L. Goldstein
    • 1
    • 2
  1. 1.Renal Section, Department of PediatricsBaylor College of MedicineHoustonUSA
  2. 2.Texas Children’s HospitalHoustonUSA
  3. 3.Critical Care Medicine Section, Department of PediatricsBaylor College of MedicineHoustonUSA

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