Nutritional requirements in critically ill patients treated with intermittent renal replacement therapy

Abstract

Acute renal failure (ARF) develops in nearly 5% of hospitalized patients [1]. However, the incidence of ARF in ICU’s settings is much higher. For example, in our own unit, nearly half of the patients (48%) are either admitted for ARF, or develop ARF as a secondary complication during the course of the primary illness. ARF in a majority of ICU’s patients is multifactorial. It frequently supervenes in uncontrolled sepsis and/or multiple organs dysfunction [2–4]. In addition, it has been recently pointed out that an increasing population of elderly patients is at particularly high risk for developing ARF during their stay in ICU’s [5–9]. Thus it is not surprising, but certainly disappointing, that the high overall mortality rate of 40 to 60% prevailing in ICU’s patients with ARF has not been significantly improved in recent years [1, 10–19]. This lack of apparent success is noteworthy because it contrasts with new technological breakthroughs in the field of renal replacement therapy and the implementation of sophisticated artificial feeding in the critically ill with ARF [20–22].