Renal failure parenteral nutrition

Other causes include magnesium-containing antacids in patients with renal insufficiency, enteral or parenteral nutrition in patients with multiorgan system failure, magnesium for treatment of eclampsia, lithium therapy, hypothyroidism, and Addison s disease. 

Duerksen DR, Papineau N. Electrolyte abnormalities in patients with chronic renal failure receiving parenteral nutrition. J Parenter Enteral Nutr 1998 22(2) 102-4. 

Patients with end-stage renal failure are maintained very fluid-restricted which limits the amount of calories that can be delivered intravenously, fritradialytic parenteral nutrition (via the dialysis solution, see Sect. 14.4.2) enables the provision of additional calories and nutritive substances [70]. 

One potential problem in the parenteral nutrition of children with acute renal failure is the presence or absence of histidine from the mix. In the "Renal Failure Intravenous Diet" (Table 1) currently in use at the Massachusetts General Hospital (Freamine-E) histidine is not part of the mixture. 

The indication for administering BCAA in patients with hepatic encephalopathy to compensate amino-acid imbalance was proposed by J.E. Fischer et al. in 1974, and implemented parenterally. However, oral application of BCAA for an adequate treatment period also has beneficial effects on cirrhosis and HE (7.) improvement in protein tolerance and the nutritional condition, (2.) improvement in cerebral functions (II8, 122), probably due to an amelioration of liver function, (2.) stimulation of ammonia detoxification with a positive nitrogen balance (118), (4.) reduction in or normalization of AAA levels, and (5.) promotion of glutamine synthesis with a favourable effect on the cells of the immune system and on renal function. By means of BCAA, it was possible to prolong the survival time and delay the occurrence of liver failure in rats with CC -induced cirrhosis. (123, 126) However, there are diverging results, which need further clarification. In principle, the use of BCAA is considered to be a necessary form of supplementary treatment for catabolic metabolism in cirrhosis (124,125, 127, 128, 130-132), in (also latent) HE and after curative resection of hepatocellular carcinoma. (I2l) (s. p. 280)... 

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