J Korean Diet Assoc.  2009 Nov;15(4):335-342.

The Calorie and Protein Intake of Critically Ill Patients Who Require Continuous Renal Replacement Therapy in the Intensive Care Unit

Affiliations
  • 1Department of Nutrition and Dietetics, Severance Hospital, Seoul 120-752, Korea.
  • 2Department of Internal Medicine, Yonsei University College of Medicine, Seoul 120-752, Korea.
  • 3Department of Anesthesiology and Pain Medicine, and Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 120-752, Korea. sokoh@yuhs.ac
  • 4Department of Surgery, Yonsei University College of Medicine, Seoul 120-752, Korea.

Abstract

Forty-two percent of the patients with renal failure that requires continuous renal replacement therapy (CRRT) have been reported to have severe malnutrition, and preexisting malnutrition is a statistically significant and independent predictor of negative hospital outcomes. We performed this study to evaluate the appropriateness of the calorie and protein provided for the critically ill patients who require CRRT. One hundred forty-nine patients who received CRRT were enrolled. The demographic data, the length of the ICU stay and the mortality were recorded. The calorie/protein intake and the blood urea nitrogen (BUN), albumin and creatinine levels were used as nutritional parameters. The mean daily calorie intake during CRRT was 16.1+/-7.4 kcal/kg, which was 64% of the recommended intake. Only 10% of the patients received the recommended caloric intake and the ratio of the enteral and parenteral calories was 26%/74%. The mean protein intake was 0.58+/-0.34 g/kg, which was 38% of the recommended intake. The calorie and protein intakes at the termination of CRRT were significantly increased compared to the initial day of treatment, but they stayed under the recommended intake. The BUN, creatinine and albumin levels were significantly increased in the survival group (odds ratio for albumin: 2.73; creatinine: 2.43). A strategy to increase the nutrition provision is needed to improve the nutritional statuses and clinical outcomes of the critically ill patients who require CRRT.

Keyword

continuous renal replacement therapy; nutrition support; calorie; protein; intensive care unit

MeSH Terms

Blood Urea Nitrogen
Creatinine
Critical Illness
Energy Intake
Humans
Critical Care
Intensive Care Units
Malnutrition
Nutritional Status
Renal Insufficiency
Renal Replacement Therapy
Creatinine
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