Most randomized controlled studies on nutrition in intensive care patients did not yield conclusive results or were neutral or negative concerning the primary endpoints but also in most secondary endpoints. However, there is a consistent observation that in several of these studies there was a negative effect of the nutrition intervention on the kidneys in one of the study arms. During the early phase and in unstable periods during further course of disease an inadequate clinical nutrition can damage the kidneys, can elicit or aggravate acute kidney injury and/ or increase requirements of renal replacement therapy (RRT). This relates to total energy intake, glucose intake/hyperglycemia and protein/ amino acid intake at various stages of renal dysfunction. The kidney could present a critical organ system for guiding nutrition therapy, a close monitoring of kidney function should be observed and nutrition therapy may need to be adapted accordingly. The long-held dogma of performing full nutrition and accept an otherwise not necessary RRT is definitely to be refuted.

中文翻译：

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肾脏：指导 ICU 患者营养治疗的关键器官系统？


大多数关于重症监护患者营养的随机对照研究没有得出结论性结果，或者在主要终点方面呈中性或阴性，但在大多数次要终点方面也是如此。然而，一致的观察结果是，在其中几项研究中，营养干预对其中一项研究组的肾脏产生了负面影响。在疾病的早期阶段和进一步病程的不稳定时期，临床营养不足可能会损害肾脏，可能引发或加重急性肾损伤和/或增加肾脏替代治疗（RRT）的需求。这与肾功能障碍各个阶段的总能量摄入、葡萄糖摄入/高血糖和蛋白质/氨基酸摄入有关。肾脏可能是指导营养治疗的关键器官系统，应密切监测肾功能，并可能需要相应地调整营养治疗。长期坚持的“提供充分营养并接受原本不必要的 RRT”的教条肯定会被驳斥。