PMID- 17556411
OWN - NLM
STAT- MEDLINE
DCOM- 20080114
LR  - 20131121
IS  - 0931-0509 (Print)
IS  - 0931-0509 (Linking)
VI  - 22
IP  - 10
DP  - 2007 Oct
TI  - Trace element removal during in vitro and in vivo continuous haemodialysis.
PG  - 2970-7
AB  - BACKGROUND: Continuous renal replacement therapy (CRRT) increasingly is being 
      used to treat critically ill patients with renal disease. CRRT removes waste 
      products but also nutrients. Our understanding of trace element CRRT clearance 
      has been limited by poor assay sensitivity. The development of inductively 
      coupled plasma mass spectrometry (ICP-MS) allows for the measurement of CRRT 
      trace element removal. METHODS: Continuous venovenous haemodialysis (CVVHD) 
      transmembrane clearances of trace elements and urea were assessed using a bovine 
      blood-based in vitro model using two different haemodialyser types. These 
      findings were validated in 10 critically ill adult patients receiving continuous 
      venovenous haemodiafiltration (CVVHDF). Calculated daily trace element loss was 
      compared with a typical dose of daily trace element supplementation. RESULTS: The 
      mean +/- SD in vitro CVVHD transmembrane clearances (ml/min) for the polysulfone 
      haemodialyser were chromium 0.97 +/- 0.23, copper 0.47 +/- 0.18, manganese 4.6 
      +/- 3.6, selenium 1.2 +/- 0.63 and zinc 2.3 +/- 0.32 and for the cellulose 
      diacetate haemodialyser chromium 1.54 +/- 0.91, copper 0.21 +/- 0.07, manganese 
      7.8 +/- 4.1, selenium 0.76 +/- 0.39 and zinc 2.7 +/- 0.37. The in vivo CVVHDF 
      transmembrane clearances (ml/min) were chromium 5.4 +/- 2.4, copper 0.45 +/- 
      0.33, manganese 1.9 +/- 4.6, selenium 1.6 +/- 1.2, and zinc 4.0 +/- 1.3. 
      CONCLUSION: ICP-MS assays detected the five trace elements in the effluent of 
      CVVHDF patients. Trace element CVVHD transmembrane clearance estimates for our in 
      vitro model were supported by the in vivo CVVHDF findings. Calculated daily trace 
      element loss attributed to CVVHD and CVVHDF with dialysate flow rates of 33.3 
      ml/min is less than what is provided in a daily dose of a trace element 
      supplementation product.
FAU - Churchwell, Mariann D
AU  - Churchwell MD
AD  - Department of Pharmacy Practice, University of Toledo College of Pharmacy, 2801 
      W. Bancroft MS 609, Toledo, OH 43606, USA. mariann.churchwell@utoledo.edu
FAU - Pasko, Deborah A
AU  - Pasko DA
FAU - Btaiche, Imad F
AU  - Btaiche IF
FAU - Jain, Jinesh C
AU  - Jain JC
FAU - Mueller, Bruce A
AU  - Mueller BA
LA  - eng
PT  - Journal Article
DEP - 20070607
PL  - England
TA  - Nephrol Dial Transplant
JT  - Nephrology, dialysis, transplantation : official publication of the European 
      Dialysis and Transplant Association - European Renal Association
JID - 8706402
RN  - 0 (Hemodialysis Solutions)
RN  - 0 (Trace Elements)
RN  - 059QF0KO0R (Water)
SB  - IM
CIN - Nephrol Dial Transplant. 2008 Apr;23(4):1462; author reply 1462-3. PMID: 18029373
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Diffusion
MH  - Female
MH  - Hemodialysis Solutions
MH  - Hemofiltration
MH  - Humans
MH  - Male
MH  - Mass Spectrometry/*methods
MH  - Middle Aged
MH  - Renal Dialysis/*instrumentation/*methods
MH  - Renal Insufficiency
MH  - Renal Replacement Therapy/*instrumentation/*methods
MH  - Reproducibility of Results
MH  - Trace Elements/*analysis
MH  - Water/chemistry
EDAT- 2007/06/09 09:00
MHDA- 2008/01/15 09:00
CRDT- 2007/06/09 09:00
PHST- 2007/06/09 09:00 [pubmed]
PHST- 2008/01/15 09:00 [medline]
PHST- 2007/06/09 09:00 [entrez]
AID - gfm352 [pii]
AID - 10.1093/ndt/gfm352 [doi]
PST - ppublish
SO  - Nephrol Dial Transplant. 2007 Oct;22(10):2970-7. doi: 10.1093/ndt/gfm352. Epub 
      2007 Jun 7.