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Electrolyte Abnormalities in Patients With Chronic Renal Failure Receiving Parenteral Nutrition
Author(s) -
Duerksen Donald R.,
Papineau Noreen
Publication year - 1998
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607198022002102
Subject(s) - hypophosphatemia , hypomagnesemia , medicine , hypokalemia , parenteral nutrition , continuous ambulatory peritoneal dialysis , peritoneal dialysis , dialysis , gastroenterology , chronic renal failure , ambulatory , magnesium , materials science , metallurgy
Background and Methods: Chronic renal failure frequently is complicated by elevations in serum potassium, phosphate, and magnesium. Consequently, parenteral nutrition (PN) solutions used to treat malnourished patients with chronic renal failure usually are prepared with little supplementation of these cations. Four malnourished patients with chronic renal failure and electrolyte abnormalities are reported. Results: Four patients developed significant hypophosphatemia 3 to 5 days after starting PN. Although carbohydrate infused via PN initially was not excessive (1.4 to 2.0 mg/kg/min), two patients received additional dextrose through continuous ambulatory peritoneal dialysis (CAPD). Two of the four patients received insulin during PN. Other electrolyte abnormalities included hypomagnesemia (1 patient) and hypokalemia (3 patients). Conclusions: Malnourished patients with chronic renal failure receiving PN are at risk of developing electrolyte abnormalities, particularly hypophosphatemia. The electrolytes of these patients should be monitored closely when nutrition support is begun, and supplementation should be started as levels begin to fall within a normal range. ( Journal of Parenteral and Enteral Nutrition 22: 102–104, 1998)