(P03-023-24) Adequate Trace Elements Intakes Might Ameliorate Major Adverse Kidney Events in Critically Ill Patients

Objectives: Critically ill patients frequently appear concurrent with acute kidney injury (AKI). Trace element (e.g., selenium, zinc, and copper) metabolism has been shown to be altered in patients with AKI. However, the association between trace element intake and clinical outcomes in critically ill patients has not been widely studied. We applied the major adverse kidney events within 28 days (MAKE28) to evaluate the clinical outcome of critically ill patients, and to assess the association of trace element intake with MAKE28 in critically ill patients.

Methods: We included patients who were older than 20 years old, and stayed in the intensive care unit (ICU) for more than 48 hours. Critically ill patients were allocated to MAKE28 or non-MAKE28 groups based on whether they met one or more criteria for MAKE28 (eg, dialysis provision, sustained loss of the kidney function, and/or death) on the 28^th day after admission to the ICU. The patients’ data were collected at the 1^st day and the 7^th day of the ICU, and included age, sex, serum white blood cell, total lymphocyte counts, creatinine, albumin and C-reactive protein, AKE occurred at admission, and APACHE II score. The mean 7-day nutrient intake from enteral nutrition and intravenous fluid infusions was recorded and calculated.

Results: 16 of 50 critically ill patients were in the MAKE28 group. AKI occurred in 58.8% and 93.8% of patients in the non-MAKE28 and MAKE28 group, respectively. The patients had similar dst and 7^th day within the group. Patients in the non-MAKE28 group had a significantly higher mean intake of protein, carbohydrate, selenium, zinc, and copper in the ICU. Mean selenium (OR, 0.954, 95% CI, 0.917 – 0.992), zinc (OR, 0.813, 95% CI, 0.692 – 0.954) and copper (OR, 0.124, 95% CI, 0.022 – 0.698) intakes were significantly associated with MAKE28 after adjusted for age and sex.

Conclusions: Adequate intake of trace elements might ameliorate major adverse kidney events in critically ill patients.

Funding Sources: This study was supported by a grant from the National Science and Technology Council, Taiwan.