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Related Experiment Videos

How to feed patients with renal dysfunction.

R Bellomo1

  • 1Department of Intensive Care, Austin and Repatriation Medical Centre, Melbourne, Australia. rinaldo.bellomo@armc.org.au

Blood Purification
|February 28, 2002
PubMed
Summary
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Critically ill patients with renal failure can receive optimal nutritional support, including enteral nutrition and immune-enhancing formulas, thanks to continuous renal replacement therapy (CRRT). This approach helps manage azotemia and fluid balance, potentially reducing complications and improving outcomes.

Area of Science:

  • Critical Care Medicine
  • Nephrology
  • Nutritional Science

Background:

  • Renal dysfunction is prevalent in critically ill patients, historically complicating nutritional support due to azotemia and fluid overload.
  • Conventional dialysis methods presented challenges in managing these complications effectively.

Purpose of the Study:

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

Main Methods:

  • Review of accumulating evidence on nutritional support in critically ill patients with renal failure undergoing CRRT.
  • Analysis of outcomes associated with specific enteral feeding regimens and immune-enhancing preparations.

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Main Results:

  • CRRT effectively manages azotemia and fluid balance, removing concerns about nutritional support in renal failure.
  • Recommended enteral intake: 30-35 kcal/kg/day, initiated early, with protein at 1.5-2 g/kg/day.
  • Immune-enhancing enteral preparations may decrease hospital stay, infections, and mortality.

Conclusions:

  • Renal failure should not preclude optimal nutritional support in critically ill patients.
  • Protocol-based nutritional support, including adequate calories, protein, immune-enhancing formulas, and micronutrient supplementation, can significantly decrease morbidity and mortality in patients with renal failure.