Fat-soluble vitamins in advanced CKD/ESKD: a review.

Patients requiring dialysis often experience a significant decline in their nutritional status through a combination of chronic disease, reduced appetite, and dietary restrictions, which places them at risk for vitamin deficiencies. The concept of vitamin deficiency has evolved from obvious deficiency states to the subtle effects that suboptimal intake may have on chronic disease prevalence or progression. The purpose of this study was to summarize the current state of knowledge regarding the status of the fat-soluble vitamins (A, D, E, and K) in patients with chronic kidney disease receiving hemodialysis.

Composition of human breast milk in acute kidney injury.

BACKGROUND: Breastfeeding is a widely encouraged practice due to its benefits for mother and the infant. Little is known about the impact of disease states, such as kidney dysfunction and childbirth complications, on the composition of breast milk. METHODS: We describe a case of a 35-year-old woman who suffered a postpartum hemorrhage, was administered a contrast dye prior to computer tomography, and developed an acute kidney injury. Using nuclear magnetic resonance spectrometry, we measured composition of milk in acute kidney injury. The amount of dye secreted into milk was determined using a spectroscopic assay. RESULTS: Here we show that acute kidney injury results in changes in milk composition, but it does not significantly affect major macronutrients. We also determine that iodinated computer tomography contrast dye does not accumulate in milk in appreciable amounts. CONCLUSION: Acute kidney injury has impact on breast milk. Intravenous administration of computer tomography contrast dye does not result in significantly elevated levels in milk.