The Japanese Journal of Clinical Dialysis Vol.35 No.6(8)

Theme Evidence and issue for clinical practice of acute kidney injury
Title Nutritional and metabolic management in AKI patients
Publish Date 2019/06
Author Akihiko Kato Blood Purification Unit, Hamamatsu University Hospital
[ Summary ] Nutritional intervention in patients with acute kidney injury (AKI) has demonstrated that: 1) permissive underfeeding may decrease the risk of incident continuous renal replacement therapy; 2) enteral feeding is preferable during an intensive care unit (ICU) stay and combined enteral and parenteral nutrition will start at 7 days after ICU admission; 3) AKI patients' hypoglycemic episodes must be carefully monitored and managed, especially in case of insulin treatment; and 4) AKI patients are prone to the development of frailty, so nutritional management and exercise rehabilitation will be required after ICU discharge long-term. Many AKI patients are elderly, so they may be suffering from post-intensive care syndrome such as sarcopenia, cognitive impairment, and mental stress after the live-saving intensive treatment. The goal of nutritional management in AKI patients is not only to shorten the period of artificial ventilation and ICU and hospital stays, but also to recover physical impairment and to prevent the development of chronic kidney disease (CKD).
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