Protein-energy wasting is common in critically ill patients with acute kidney injury. Renal replacement therapy (RRT) has negative effects on nutrient balance and can further deteriorate nutritional status. The prescribed dialysis modality is a determinant of micronutrient and amino acid losses, with continuous RRT (CRRT) leading to the greatest losses. It is essential to assess and monitor the nutritional status in any RRT modality, implementing conventional nutritional assessment tools (SGA) and technologies for monitoring hydration and body composition (BIA, US). Nutritional therapy should be initiated early via the enteral route, and if nutritional requirements cannot be achieved, parenteral nutrition can be implemented. Energy requirements range from 20−30 kcal/kg/day (quantifying nutritional/non-nutritional calories), and protein intake is 1.3−1.5 g/kg/day with conventional intermittent RRT, and 1.5–1.7 g/kg/day with prolonged intermittent and continuous RRT.
Osuna-Padilla et al. (Fri,) studied this question.