Serum Nutrient Alterations in Chronic Renal Disease

Abstract

Serum nutrient alterations represent a balance between ingestion, excretion and utilization. Among the functions of the kidney, one of the longest and best recognized is that of excretion. In children with renal disease, excretion of certain metabolic products is limited. Especially significant is the increase in the serum of metabolic nitrogen compounds, hydrogen ion, organic acids, phenols, phosphate, potassium, sodium, chloride and water. In contrast, in those with renal tubular disease, excessive losses may occur, particularly of phosphate, bicarbonate, sodium, chloride, potassium, and water. Amino acids may be retained in glomerular or lost in tubular disease and this loss is responsible for so-called urinary amino-acidopathies. Secondary serum alterations may occur, such as lowered serum calcium and increased parathormone in the presence of phosphate retention. Other minerals, vitamins, and energy may also be excreted, depending on the type of disease.