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Nutrition in acute renal failure.
1Intensive Care Unit, Kuopio University Central Hospital, Finland.
Critical Care Clinics
|January 1, 1987
Summary
Nutritional support is crucial for acute renal failure (ARF) patients who are often hypercatabolic. Parenteral nutrition is typically used, with energy and amino acid needs requiring frequent adjustment based on patient response.
Area of Science:
- Nephrology
- Critical Care Medicine
- Nutritional Support
Background:
- Acute renal failure (ARF) complicates severe illness or injury, leading to superimposed metabolic changes.
- Patients with ARF are frequently hypercatabolic, increasing the risk of rapid nutritional depletion.
- Effective management requires early dialysis, vital sign monitoring, and metabolic therapy.
Purpose of the Study:
- To outline the principles of nutritional management in patients with acute renal failure.
- To emphasize the role of parenteral nutrition when enteral feeding is not feasible.
- To provide guidelines for energy and amino acid administration in ARF.
Main Methods:
- Review of general treatment principles for ARF, including dialysis and metabolic monitoring.
- Discussion of the feasibility and application of total parenteral nutrition (TPN) in ARF.
- Calculation of recommended daily intake of energy and amino acids for ARF patients.
Main Results:
- Enteral nutrition is often not feasible in ARF, necessitating TPN.
- Fluid volume is not a limiting factor for TPN with adequate dialysis or filtration.
- Recommended TPN: 35-40 kcal/kg/day (fat/glucose) and 1 g/kg/day amino acids (essential/nonessential).
Conclusions:
- Nutritional therapy is integral to supportive care for acute renal failure.
- TPN is the primary mode of nutritional support in ARF, with adjustable nutrient levels.
- Precise nutritional requirements in ARF remain to be fully elucidated and necessitate ongoing patient monitoring.