Acute Kidney Injury Incidence in Hospitalized Patients and Implications for Nutrition Support

Meyer, Daniel M.; Mohan, Anju; Subev, Emiliya; Sarav, Menaka; Sturgill, Daniel

doi:10.1002/ncp.10595

Cited by 17 publications

(12 citation statements)

References 115 publications

(218 reference statements)

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“…Some nutrition screening tools, such as NRS-2002 [ 22 ], Patient-Generated Subjective Global Assessment (PG-SGA) [ 23 ] and mNUTRIC score, all include age. Malnutrition is often found in patients with acute kidney injury (AKI) [ 3 , 5 , 24 ], and it is an independent risk factor for poor prognosis in critically ill patients [ 25 , 26 ]. It affects the occurrence and development of AKI independently of non-nutritional factors, increases in-hospital mortality, prolongs hospitalization time and increases hospitalization expenses [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of malnutrition risk in elderly patients with acute kidney injury in the intensive care unit

Wang

et al. 2022

BMC Nephrol

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Background Malnutrition is common in critically ill patients, but nutrition status in critically ill patients with acute kidney injury (AKI) has been poorly studied. Our study aimed to investigate the relationship between malnutrition risk and the occurrence and prognosis of AKI in elderly patients in the intensive care unit (ICU). Methods Data were extracted from the Beijing Acute Kidney Injury Trial (BAKIT). A total of 1873 elderly patients were included and compared according to the clinical characteristics of AKI and non-AKI groups, and those of survivors and non-survivors of AKI in this study. Receiver operating characteristic (ROC) curves were used to analyse the predictive value of the modified Nutrition Risk in Critically Ill (mNUTRIC) score for the occurrence and 28-day prognosis of AKI. Multivariate Cox regression analysis was used to evaluate the effect of the mNUTRIC score on the 28-day mortality in AKI patients. Results Compared with the non-AKI group, AKI patients had higher mNUTRIC scores, and non-survivors had higher mNUTRIC scores than survivors in AKI population. Moreover, multivariate Cox regression showed that 28-day mortality in AKI patients increased by 9.8% (95% CI, 1.018-1.184) for every point increase in the mNUTRIC score, and the mNUTRIC score had good predictive ability for the occurrence of AKI and 28-day mortality in AKI patients. The mortality of AKI patients with mNUTRIC > 4 was significantly increased. Conclusions The elderly patients are at high risk of malnutrition, which affects the occurrence and prognosis of AKI. Adequate attention should be given to the nutritional status of elderly patients. Trial registration This study was registered at www.chictr.org.cn (registration number Chi CTR-ONC-11001875) on 14 December 2011.

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Section: Discussionmentioning

confidence: 99%

Prognostic significance of malnutrition risk in elderly patients with acute kidney injury in the intensive care unit

Wang

et al. 2022

BMC Nephrol

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“…AKI is a very common clinical problem, especially in hospitalized patients, affecting 57.3% of patients in intensive care units [ 50 ]. The mortality of AKI is estimated to be 26.9% and increases up to 55.3% among patients who need kidney replacement therapy [ 51 ].…”

Section: Kidney Diseasesmentioning

confidence: 99%

“…The standard laboratory marker used to monitor renal function, i.e. serum creatinine, is useless in elderly or malnourished patients as well as in rapid decline in kidney function [ 50 ]. Due to inconclusive results of studies in AKI animal models and the nonavailability of most potential AKI biomarkers in clinical practice [ 53 , 54 ], the search for other AKI indicators is crucial.…”

Section: Kidney Diseasesmentioning

confidence: 99%

Kynurenine pathway in kidney diseases

Zakrocka

Załuska

2021

Pharmacol. Rep

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Kidney diseases have become one of the most common health care problems. Due to a growing number of advanced aged patients with concomitant disorders the prevalence of these diseases will increase over the coming decades. Despite available laboratory tests, accurate and rapid diagnosis of renal dysfunction has yet to be realized, and prognosis is uncertain. Moreover, data on diagnostic and prognostic markers in kidney diseases are lacking. The kynurenine (KYN) pathway is one of the routes of tryptophan (Trp) degradation, with biologically active substances presenting ambiguous properties. The KYN pathway is known to be highly dependent on immunological system activity. As the kidneys are one of the main organs involved in the formation, degradation and excretion of Trp end products, pathologies involving the kidneys result in KYN pathway activity disturbances. This review aims to summarize changes in the KYN pathway observed in the most common kidney disease, chronic kidney disease (CKD), with a special focus on diabetic kidney disease, acute kidney injury (AKI), glomerulonephritis and kidney graft function monitoring. Additionally, the importance of KYN pathway activity in kidney cancer pathogenesis is discussed, as are available pharmacological agents affecting KYN pathway activity in the kidney. Despite limited clinical data, the KYN pathway appears to be a promising target in the diagnosis and prognosis of kidney diseases. Modulation of KYN pathway activity by pharmacological agents should be considered in the treatment of kidney diseases.

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“…Formula selection may be dependent on treatment plan, whether a patient is receiving renal replacement therapy, presence of comorbidities, and overall clinical status 3,31,32 . Patients with acute kidney injury (AKI), chronic kidney disease (CKD) Stages 1–5D and posttransplant may be at risk for malnutrition, loss of protein and energy stores, and micronutrient deficiencies 31 . Nutrition status should be considered an important factor in the clinical assessment of the patient and may affect formula selection 31,32 .…”

Section: Review Of En Formulationsmentioning

confidence: 99%

“…31 Nutrition status should be considered an important factor in the clinical assessment of the patient and may affect formula selection. 31,32 Patients with CKD with no plans for dialysis may benefit from a calorically dense, volume-restricted formula with lower levels of protein and electrolytes (potassium, phosphorus, magnesium). 16 Patients receiving dialysis may benefit from a calorically dense, volume-restricted, high-protein formula and may or may not need a reduction of potassium, phosphorus, and magnesium.…”

Section: Renal Formulasmentioning

confidence: 99%

Enteral nutrition product formulations: A review of available products and indications for use

Church

Zoeller

2023

Nut in Clin Prac

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When oral nutrition is not feasible, enteral nutrition (EN) therapy is often considered the preferred route of nutrition support to meet the nutrient needs of individuals with a functional gastrointestinal tract across multiple levels of care (critical care, acute care, and home care). Enteral formulations have progressively evolved over the last 50 years from the simple blending of hospital food thin enough to run through a feeding tube, to the development of commercial standard formulas, followed by specialized formulas with immune-modulating and disease-specific qualities, to the most recent shift to food-based or blenderized EN composed of natural, whole foods with perceived health benefits. With the vast number of enteral formulations on the market, clinicians may be overwhelmed trying to determine proven vs theoretical benefits. This review is intended to explore differences in enteral formulations, identify implications for clinical practice, and review evidencedbased clinical guidelines to assist clinicians in enteral formula selection.

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Acute Kidney Injury Incidence in Hospitalized Patients and Implications for Nutrition Support

Cited by 17 publications

References 115 publications

Prognostic significance of malnutrition risk in elderly patients with acute kidney injury in the intensive care unit

Prognostic significance of malnutrition risk in elderly patients with acute kidney injury in the intensive care unit

Kynurenine pathway in kidney diseases

Enteral nutrition product formulations: A review of available products and indications for use

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