Concentrations of some trace elements (Se, Zn, Cu, Fe) in hemofiltrate of critically ill patients treated by continuous veno-venous hemofiltraton (CVVH)

The treatment of acute renal failure (ARF) with continuous veno-venous hemofiltration (CVVH) may improve the prognosis of critically ill patients. Losses of trace elements during CVVH could influence the nutritional balance and the clinical outcome. The concentration of selen (Se), copper (Cu) and zinc (Zn) was measured in serum and hemofiltrate of 15 patients with ARF, and iron (Fe) in hemofiltrate of only 10 patients. A general deficiency of Se, Cu, and Zn in serum was not detected, the concentrations of these trace elements in hemofiltrate showed no relationship to the serum concentration, nevertheless, the daily mean removal is equal or greater than the daily needed amounts estimated in normal patients. Fe could not be detected in hemofiltrate. A normal substitution or an increase of the amounts of these trace elements given previously cannot generally be recommended. The regular detection of these trace elements can prevent deficiency states and can indicate the start of substitution.