open access

Vol 49, No 4 (2017)
Review articles
Published online: 2017-10-12
Submitted: 2017-09-11
Accepted: 2017-10-12
Get Citation

Practical issues of nutrition during continuous renal replacement therapy

Dariusz Onichimowski, Radosław Goraj, Rakesh Jalali, Jolanta Grabala, Ewa Mayzner-Zawadzka, Mirosław Czuczwar
DOI: 10.5603/AIT.a2017.0052
·
Pubmed: 29027657
·
Anaesthesiol Intensive Ther 2017;49(4):309-316.

open access

Vol 49, No 4 (2017)
Review articles
Published online: 2017-10-12
Submitted: 2017-09-11
Accepted: 2017-10-12

Abstract

Continuous renal replacement therapy (CRRT) in critically ill patients has significant impact on one’s ability to provide efficient nutritional therapy. CRRT may help in the prevention of intestinal oedema and the maintenance of the proper function of the gastrointestinal tract by enabling strict control of the fluid balance. It facilitates early introduction of nutrition via the enteral route, as well as allowing for the composition of high-volume feeding mixtures. It is necessary to take into consideration that during CRRT, together with blood purification of toxic substances, nutritive elements are also eliminated to some extent (micro- and macronutrients). In this article, the authors discuss the impact of CRRT on nutritive elements loss, energetic balance and present the principles of adjusting feeding prescriptions to changes implied by CRRT.

Abstract

Continuous renal replacement therapy (CRRT) in critically ill patients has significant impact on one’s ability to provide efficient nutritional therapy. CRRT may help in the prevention of intestinal oedema and the maintenance of the proper function of the gastrointestinal tract by enabling strict control of the fluid balance. It facilitates early introduction of nutrition via the enteral route, as well as allowing for the composition of high-volume feeding mixtures. It is necessary to take into consideration that during CRRT, together with blood purification of toxic substances, nutritive elements are also eliminated to some extent (micro- and macronutrients). In this article, the authors discuss the impact of CRRT on nutritive elements loss, energetic balance and present the principles of adjusting feeding prescriptions to changes implied by CRRT.

Get Citation

Keywords

critical care, nutrition; kidney injury; continuous renal replacement therapy, energy requirements, protein needs

About this article
Title

Practical issues of nutrition during continuous renal replacement therapy

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 49, No 4 (2017)

Pages

309-316

Published online

2017-10-12

DOI

10.5603/AIT.a2017.0052

Pubmed

29027657

Bibliographic record

Anaesthesiol Intensive Ther 2017;49(4):309-316.

Keywords

critical care
nutrition
kidney injury
continuous renal replacement therapy
energy requirements
protein needs

Authors

Dariusz Onichimowski
Radosław Goraj
Rakesh Jalali
Jolanta Grabala
Ewa Mayzner-Zawadzka
Mirosław Czuczwar

References (19)
  1. Bendavid I, Singer P, Theilla M, et al. NutritionDay ICU: A 7 year worldwide prevalence study of nutrition practice in intensive care. Clin Nutr. 2017; 36(4): 1122–1129.
  2. Zusman O, Theilla M, Cohen J, et al. Resting energy expenditure, calorie and protein consumption in critically ill patients: a retrospective cohort study. Crit Care. 2016; 20(1): 367.
  3. Honoré PM, De Waele E, Jacobs R, et al. Nutritional and metabolic alterations during continuous renal replacement therapy. Blood Purif. 2013; 35(4): 279–284.
  4. Maynar J, Honore PM, Sanchez-Izquierdo JA, et al. Handling CRRT-related adverse effects in ICU patients: the dialytrauma concept. Blood Purif. 2012; 34: 177–187.
  5. Casaer MP, Van den Berghe G, Casaer MP, et al. Nutrition in the acute phase of critical illness. N Engl J Med. 2014; 370(13): 1227–1236.
  6. Singer P, Anbar R, Cohen J, et al. The tight calorie control study (TICACOS): a prospective, randomized, controlled pilot study of nutritional support in critically ill patients. Intensive Care Med. 2011; 37(4): 601–609.
  7. Rugeles S, Villarraga-Angulo LG, Ariza-Gutiérrez A, et al. High-protein hypocaloric vs normocaloric enteral nutrition in critically ill patients: A randomized clinical trial. J Crit Care. 2016; 35: 110–114.
  8. Scheinkestel CD, Adams F, Mahony L, et al. Impact of increasing parenteral protein loads on amino acid levels and balance in critically ill anuric patients on continuous renal replacement therapy. Nutrition. 2003; 19(9): 733–740.
  9. Singer P, Hiesmayr M, Biolo G, et al. Pragmatic approach to nutrition in the ICU: Expert opinion regarding which calorie protein target. Clinical Nutrition. 2014; 33(2): 246–251.
  10. Novak F, Heyland DK, Avenell A, et al. Glutamine supplementation in serious illness: a systematic review of the evidence. Crit Care Med. 2002; 30(9): 2022–2029.
  11. Andrews PJD, Avenell A, Noble DW, et al. Scottish Intensive care Glutamine or seleNium Evaluative Trial Trials Group, Trials Management Group. Randomised trial of glutamine and selenium supplemented parenteral nutrition for critically ill patients. Protocol Version 9, 19 February 2007 known as SIGNET (Scottish Intensive care Glutamine or seleNium Evaluative Trial). Trials. 2007; 8: 25.
  12. Heyland D, Muscedere J, Wischmeyer PE, et al. Canadian Critical Care Trials Group. A randomized trial of glutamine and antioxidants in critically ill patients. N Engl J Med. 2013; 368(16): 1489–1497.
  13. Mottaghi A, Yeganeh MZ, Golzarand M, et al. Efficacy of glutamine-enriched enteral feeding formulae in critically ill patients: a systematic review and meta-analysis of randomized controlled trials. Asia Pac J Clin Nutr. 2016; 25(3): 504–512.
  14. Marik PE, Zaloga GP. Immunonutrition in critically ill patients: a systematic review and analysis of the literature. Intensive Care Med. 2008; 34(11): 1980–1990.
  15. Kazory A, Clapp WL, Ejaz AA, et al. Shortened hemofilter survival time due to lipid infusion in continuous renal replacement therapy. Nephron Clin Pract. 2008; 108(1): c5–c9.
  16. Santoro A, Mancini E, London G, et al. Patients with complex arrhythmias during and after haemodialysis suffer from different regimens of potassium removal. Nephrol Dial Transplant. 2008; 23(4): 1415–1421.
  17. Brain M, Anderson M, Parkes S, et al. Magnesium flux during continuous venovenous haemodiafiltration with heparin and citrate anticoagulation. Crit Care Resusc. 2012; 14(4): 274–282.
  18. Liu C, Mao Z, Kang H, et al. Regional citrate versus heparin anticoagulation for continuous renal replacement therapy in critically ill patients: a meta-analysis with trial sequential analysis of randomized controlled trials. Crit Care. 2016; 20(1): 144.
  19. Koekkoek WA, van Zanten ARH. Antioxidant Vitamins and Trace Elements in Critical Illness. Nutr Clin Pract. 2016; 31(4): 457–474.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

VM Media sp. z o.o. VM Group sp.k., Grupa Via Medica, Świętokrzyska 73 St., 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl