Micronutrient Strategy in Critically Ill AKI Patients: Balancing Oxidative Stress, Inflammation, and CRRT Losses

Yin-Yi Han Speaker Micronutrient Strategy in Critically Ill AKI Patients: Balancing Oxidative Stress, Inflammation, and CRRT LossesAcute kidney injury is common in critically ill patients and is frequently accompanied by systemic inflammation, oxidative stress, mitochondrial dysfunction, immune dysregulation, and metabolic instability. In this context, micronutrients are not merely supportive supplements; they serve as essential cofactors for antioxidant defense, immune competence, endothelial integrity, energy metabolism, and tissue repair. However, micronutrient management in critically ill patients with AKI is challenging because of increased requirements, difficulty in assessing deficiency, impaired renal clearance, and substantial losses during continuous renal replacement therapy (CRRT). This lecture will discuss practical micronutrient strategies for critically ill patients with AKI, focusing on key nutrients such as thiamine, vitamin C, vitamin D, selenium, zinc, copper, and other trace elements. Their biological roles, potential CRRT-related losses, clinical relevance, and safety considerations will be reviewed. Based on current evidence and clinical experience, a risk-adapted, phase-based approach will be proposed to balance deficiency correction, metabolic resilience, and avoidance of excessive supplementation in this vulnerable population.