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Nutrients
Volume 15
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10.3390/nu15010063
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Article

Impact of Continuous Veno-Venous HemoDiALYsis with Regional Citrate Anticoagulation on Non-NUTRItional Calorie Balance in Patients on the ICU—The NUTRI-DAY Study

by
Simon Wechselberger
*,
Friederike Compton
and
Johannes Schilling
Medizinische Klinik m.S. Nephrologie und Internistische Intensivmedizin, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
*
Author to whom correspondence should be addressed.
Nutrients 2023, 15(1), 63; https://doi.org/10.3390/nu15010063
Submission received: 16 November 2022 / Revised: 19 December 2022 / Accepted: 20 December 2022 / Published: 23 December 2022
(This article belongs to the Section Nutrition and Public Health)
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Abstract

Background: Malnutrition as well as overfeeding can have negative impacts on clinical outcomes in critically ill patients. Continuous veno-venous hemodialysis (CVVHD) with regional citrate anticoagulation (RCA) using trisodium citrate 4% (TSC) might play a role in nutrient disposition in patients in the ICU. Methods: In 33 consecutive patients on CVVHD with RCA, energy uptake or loss was calculated. Three macronutrients (lactate, glucose and citrate) were analyzed by taking prefilter blood and effluent samples. Results: Glucose and lactate clearance through CVVHD made up for a loss of 61 kcal/d (IQR 25–164 kcal/d) and 38 kcal/d (IQR 23–59 kcal/d), respectively. Two patients with hyperglycemic state (>350 mg/dL) lost around 600 kcal/d during CVVHD. Net post-filter citrate caloric delivery through RCA was 135 kcal/d (IQR: 124–144 kcal/d). Adding the three macronutrients, net caloric gain through CVVHD was 10 kcal/d (IQR: −63–75 kcal/d). Conclusion: In non-hyperglycemic patients on CVVHD with RCA, the metabolic contribution of the three macronutrients lactate, glucose and citrate is neglectable.
Keywords: acute kidney injury; continuous renal replacement therapy; nutritional support acute kidney injury; continuous renal replacement therapy; nutritional support

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MDPI and ACS Style

Wechselberger, S.; Compton, F.; Schilling, J. Impact of Continuous Veno-Venous HemoDiALYsis with Regional Citrate Anticoagulation on Non-NUTRItional Calorie Balance in Patients on the ICU—The NUTRI-DAY Study. Nutrients 2023, 15, 63. https://doi.org/10.3390/nu15010063

AMA Style

Wechselberger S, Compton F, Schilling J. Impact of Continuous Veno-Venous HemoDiALYsis with Regional Citrate Anticoagulation on Non-NUTRItional Calorie Balance in Patients on the ICU—The NUTRI-DAY Study. Nutrients. 2023; 15(1):63. https://doi.org/10.3390/nu15010063

Chicago/Turabian Style

Wechselberger, Simon, Friederike Compton, and Johannes Schilling. 2023. "Impact of Continuous Veno-Venous HemoDiALYsis with Regional Citrate Anticoagulation on Non-NUTRItional Calorie Balance in Patients on the ICU—The NUTRI-DAY Study" Nutrients 15, no. 1: 63. https://doi.org/10.3390/nu15010063

APA Style

Wechselberger, S., Compton, F., & Schilling, J. (2023). Impact of Continuous Veno-Venous HemoDiALYsis with Regional Citrate Anticoagulation on Non-NUTRItional Calorie Balance in Patients on the ICU—The NUTRI-DAY Study. Nutrients, 15(1), 63. https://doi.org/10.3390/nu15010063

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