Current status of nutritional provision and effects of nutritional support on the clinical outcomes of acute kidney injury requiring continuous renal replacement therapy in the surgical intensive care unit

Asia Pac J Clin Nutr. 2023 Sep;32(3):321-329. doi: 10.6133/apjcn.202309_32(3).0003.

Abstract

Background and objectives: Patients with acute kidney injury requiring continuous renal replacement therapy are at high risk of malnutrition. Nutritional support is an important part of treatment for patients with critical illness admitted to the intensive care unit. We aimed to investigate the status of nutritional provision and the effects of nutritional support on clinical outcomes.

Methods and study design: Our institution's medical records (from January 1, 2020, to December 31, 2021) were analyzed in this retrospective cohort study. We included 43 patients aged >18 years who received continuous renal replacement therapy for acute kidney injury in the surgical intensive care unit.

Results: The demographic characteristics were similar between the survivor and non-survivor groups. The protein supply per body weight (0.88 ± 0.37 g/kg vs. 0.47 ± 0.53 g/kg, p = 0.029) and the proportion of patients who met the target protein level (58.9 ± 24.9% vs. 30.8 ± 34.9%, p = 0.022) were significantly higher in the survivor group. Approximately 79.1% of the patients had a high malnutrition risk with a modified Nutrition Risk in the Critically Ill score of ≥5. The lengths of hospital and intensive care unit stays were longer in the high nutritional risk group compared with that in the low nutritional risk group, but the result was not significant.

Conclusions: The nutritional amount provided in patients with critical illness is significantly lesser than the recommended amount. Ensuring proper nutritional support can improve the clinical outcomes.

Keywords: acute kidney injury; continuous renal replacement therapy; intensive care unit; nutritional support.

MeSH terms

  • Acute Kidney Injury* / therapy
  • Continuous Renal Replacement Therapy*
  • Critical Care
  • Critical Illness / therapy
  • Humans
  • Intensive Care Units
  • Malnutrition*
  • Nutritional Support
  • Renal Replacement Therapy
  • Retrospective Studies