Zinc Deficiency

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I have a 30 year post op jejunal intestinal bypass patient with major malabsorption issues. He weighed 400# 30 years ago prior to the surgery and maintaine his wt at 190# with no real problemsHe is now on dialysis for 6 years and i have been working with him for 4 years. He seems to have declined in the past year and can't seem to get his albumin above 2.0. He has been on IDPN for 8months receiving 112 grams protein per treatment with extra MVI and trace elements added yet he continues to be deficient in Zinc, magnesium. He has had times when he had night blindness and was supplemented with IV VIt A. He currently takes TWO Diatx ZN oral vitamins as well so his folate is great. He is receiving 25 mg zinc oxide in each tablet and 5 mcg folic acid.. He also gets 5 mg zinc in his IDPN. He eats greater than 3500calories and 150 grams of protein in his diet but prealbumin is now at 18 as well. His alkaline

phosphatase is very elevated so we drew a fractionated alkaline phosphatase to determine if it is bone turnover or if it is liver. BOTH bone isoenzyme and liver isoenzyme were elevated but liver isoenyme was at 435 (reference range is 13-92) I was wondering if any of you have had experience with this type of patient and if you have had the hypoalbuminemia such as this? Do any of you have any suggestions for any further interventions? on, RD, LD Renal Dietitian Houston, TX charrisonrd@...netters56 <J@...> wrote: We are getting ready to start the Lap Bands at our hospital and I am looking for Post-op Diet Guidelines & Vitamin/Mineral recommendations that I can provide to

our patients. Anything you can provide is great appreciated!