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Related Experiment Videos

How to feed patients with renal dysfunction.

Rinaldo Bellomo1, Claudio Ronco

  • 1Department of Intensive Care, Austin & Repatriation Medical Centre, Melbourne, Australia; Divisione di Nefrologia, Ospedale San Bortolo, Vicenza, Italy.

Current Opinion in Critical Care
|May 1, 2001
PubMed
Summary
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Critically ill patients with renal dysfunction can receive optimal nutritional support. Continuous renal replacement therapy (CRRT) manages fluid balance and azotemia, allowing for recommended enteral nutrition and protein intake.

Area of Science:

  • Nephrology
  • Critical Care Medicine
  • Clinical Nutrition

Background:

  • Renal dysfunction is prevalent in critically ill patients, complicating nutritional support due to azotemia and fluid overload.
  • Conventional dialysis methods presented challenges in managing these complications effectively.
  • The advent of continuous renal replacement therapy (CRRT) has addressed these concerns.

Purpose of the Study:

  • To evaluate the impact of CRRT on nutritional support strategies for critically ill patients with renal failure.
  • To provide evidence-based recommendations for nutritional management in this patient population.

Main Methods:

  • Review of existing evidence on nutritional support in critically ill patients with renal dysfunction.
  • Analysis of the role of CRRT in managing fluid balance and azotemia.

Related Experiment Videos

  • Evaluation of the efficacy of enteral nutrition, protein intake, and immune-enhancing preparations.

    • Main Results:

    • CRRT enables predictable control of azotemia and fluid balance, removing previous concerns for nutritional support.
    • Recommended enteral nutrition: 30-35 kCal/kg/d, initiated early.
    • Recommended protein intake: 1.5-2 g/kg/d.
    • Immune-enhancing enteral preparations may reduce hospital stay, infections, and mortality.
    • Vitamin and trace element supplementation is crucial due to potential losses during CRRT.

    Conclusions:

    • Renal failure should not preclude aggressive nutritional support in critically ill patients.
    • A protocol-based approach to nutritional support, including adequate energy, protein, immune-enhancing formulas, and micronutrients, can significantly decrease morbidity and mortality.