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Nutrition in Critically Ill Children with AKI on Continuous RRT: Consensus Recommendations.

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This study provides 44 clinical practice points for nutrition in critically ill children with acute kidney injury (AKI) receiving continuous renal replacement therapy (CRRT). These guidelines address assessment, energy needs, and nutrient intake for better patient outcomes.

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Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine
  • Clinical Nutrition

Background:

  • Nutrition is crucial for critically ill children, especially those with acute kidney injury (AKI).
  • Lack of established guidelines for pediatric AKI patients undergoing continuous renal replacement therapy (CRRT) necessitates clear nutritional strategies.
  • Understanding metabolic changes and nutritional challenges in AKI and CRRT is essential for effective management.

Purpose of the Study:

  • To develop clinical practice points for the nutritional assessment and management of critically ill children with AKI receiving CRRT.
  • To provide evidence-based recommendations for optimizing nutrition therapy in this vulnerable pediatric population.

Main Methods:

  • A comprehensive literature search was conducted across PubMed, MEDLINE, Cochrane, and Embase databases for articles up to January 2023.
  • Expert consensus from a multidisciplinary workgroup, including pediatric nephrologists and nutritionists, was utilized.
  • The modified Delphi method was employed to refine and finalize the clinical practice points.

Main Results:

  • A thorough review of existing literature was performed by a panel of pediatric nephrology and nutrition experts.
  • The expert panel synthesized literature findings with their clinical expertise to formulate practice recommendations.
  • The modified Delphi method facilitated a consensus-driven approach to identify and refine key clinical practice points.

Conclusions:

  • Forty-four clinical practice points have been established for nutrition assessment and management in pediatric AKI patients on CRRT.
  • These points cover crucial aspects including energy requirements and nutrient intake.
  • The guidelines are based on current literature and the collective expertise of a multidisciplinary panel.