Yanowsky Escatell, Francisco Gerardo; PazarÃn VillaseÃ±or, Leonardo; Andrade Sierra, Jorge; Santana Arciniega, Christian; Zambrano Velarde, Miguel Ãngel; Preciado Figueroa, Francisco MartÃn; Galeno SÃ¡nchez, Rogelio Ignacio
Protein-energy wasting (PEW) is highly prevalent in patients with acute kidney injury (AKI), increasing mortality, complications and use of health resources. The goals of nutritional support (NS) include: adequate intake of nutrients, prevent PEW, preservation of lean body mass, maintenance of nutritional status, avoidance of further metabolic derangements, enhancement of wound healing, support of immune function and reduction in mortality. Patients with AKI on renal replacement therapy (RRT) should receive at least 1.5 g/kg/d of protein and not more than 30 nonprotein kcal/kg/d. It should be taken into account losses macronutrients and micronutrients specially in the different types of RRT, metabolic alterations and underfeeding or overfeeding. Enteral nutrition should be the first choice of feeding, however, alone or complementary parenteral nutrition should be used to achieve nutritional goals. NS should be early in the first 24-48 hrs. The nutritional requirements and type of NS should be frequently reassessed and individualized in patients with AKI.