Nutritional recommendations for critically ill patients with acute kidney injury: an integrative review
DOI:
https://doi.org/10.55892/jrg.v9i20.2845Keywords:
Acute kidney injury, Intensive Care Units, Critical Illness, Nutrition, Recommended dietary allowancesAbstract
Acute Kidney Injury (AKI) is frequent in critically ill patients and is associated with metabolic alterations that hinder nutritional support, especially when Renal Replacement Therapy (RRT) is necessary. This study conducted an integrative literature review to describe nutritional recommendations for critically ill adults with AKI. The PubMed, SciELO, and BVS databases were searched, including studies and guidelines published in the last 10 years. Of the 195 studies found, 20 were included in the final analysis. In general, an energy intake of 20–30 kcal/kg/day is recommended, and protein intake adjusted according to the dialysis modality, ranging from 1.0 to 2.5 g/kg/day, is advised. Carbohydrate management should prioritize glycemic control between 110–180 mg/dL, considering gains or losses from dialysate. Lipid intake typically ranges from 0.8–1.0 g/kg/day and may include emulsions rich in polyunsaturated fatty acids. Patients on renal replacement therapy (RRT) may experience significant losses of water-soluble micronutrients, reinforcing the need for individualized monitoring and supplementation. The findings highlight knowledge gaps, especially regarding ideal nutrient doses and their impact on clinical outcomes.
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