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Nutrition Disorders During Acute Renal Failure and Renal Replacement Therapy
Author(s) -
Wiesen Patricia,
Van Overmeire Lionel,
Delanaye Pierre,
Dubois Bernard,
Preiser JeanCharles
Publication year - 2011
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607110377205
Subject(s) - renal replacement therapy , medicine , parenteral nutrition , medical nutrition therapy , dietary reference intake , micronutrient , renal function , intensive care medicine , vitamin , endocrinology , chemistry , nutrient , pathology , organic chemistry
The physiological and biological modifications related to acute renal failure in critically ill patients, including the current use of continuous renal replacement therapies, have dramatically changed the type and importance of the metabolic and nutrition disturbances observed during treatment of renal failure. This review summarizes the current knowledge and makes recommendations for the daily nutrition management of these patients. The filtration of water‐soluble substances of low molecular weight by continuous hemodiafiltration results in significant losses of glucose, amino acids, low‐molecular‐weight proteins, trace elements, and water‐soluble vitamins. The losses of these macronutrients and micronutrients should be compensated for. During continuous renal replacement therapy, the daily recommended energy allowance is between 25 and 35 kcal/kg, with a ratio of 60%–70% carbohydrates to 30%–40% lipids, and between 1.5 and 1.8 g/kg protein. Providing energy 25–35 kcal/kg/d with a carbohydrate/lipid ratio of 60–70/30–40 and protein 1.5–1.8 g/kg/d is recommended during continuous renal replacement therapy. Supplemental vitamin B 1 (100 mg/d), vitamin C (250 mg/d), and selenium (100 mcg/d) are also recommended.