Recomendações nutricionais em pacientes críticos com lesão renal aguda: uma revisão integrativa
DOI:
https://doi.org/10.55892/jrg.v9i20.2845Palavras-chave:
Lesão renal aguda, Unidade de Terapia Intensiva, Paciente crítico, Nutrição, Recomendações nutricionaisResumo
A Lesão Renal Aguda (LRA) é frequente em pacientes críticos e está associada a alterações metabólicas que dificultam o suporte nutricional, especialmente quando há necessidade de Terapia Substitutiva Renal (TSR). Este estudo realizou uma revisão integrativa da literatura com o objetivo de descrever recomendações nutricionais para adultos criticamente enfermos com LRA. Foram pesquisadas as bases PubMed, Scielo e BVS, incluindo estudos e diretrizes publicados nos últimos 10 anos. Dos 195 estudos encontrados, 20 foram incluídos na análise final. De modo geral, recomenda-se ingestão energética de 20–30 kcal/kg/dia e aporte proteico ajustado conforme modalidade dialítica, podendo variar de 1,0 a 2,5 g/kg/dia. O manejo de carboidratos deve priorizar controle glicêmico entre 110–180 mg/dL, considerando ganhos ou perdas provenientes do dialisato. A oferta lipídica habitualmente situa-se entre 0,8–1,0 g/kg/dia, podendo incluir emulsões ricas em ácidos graxos poli-insaturados. Pacientes em TSR podem apresentar perdas significativas de micronutrientes hidrossolúveis, o que reforça a necessidade de monitoramento e suplementação individualizada. Os achados evidenciam lacunas de conhecimento, especialmente quanto às doses ideais de nutrientes e ao impacto sobre desfechos clínicos.
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