Nutrition in Critically Ill Children with AKI on Continuous RRT: Consensus Recommendations

Abstract

Background: Nutrition plays a vital role in the outcome of critically ill children, particularly those with acute kidney injury (AKI). Currently, there are no established guidelines for children with AKI treated with continuous kidney replacement therapy (CKRT). A thorough understanding of the metabolic changes and nutritional challenges in AKI and CKRT is required. Our objective was to create clinical practice points for nutritional assessment and management in critically ill children with AKI receiving CKRT. Methods: PubMed, MEDLINE, Cochrane, and EMBASE databases were searched for articles related to the topic. Expertise of the authors and a consensus of the workgroup were additional sources of data in the article. Available articles on nutrition therapy in pediatric patients receiving CKRT through January 2023. Results: Based on the literature review, the current evidence base was examined by a panel of experts in pediatric nephrology and nutrition. The panel utilized the literature review as well as their expertise to formulate clinical practice points. The modified Delphi method was used to identify and refine clinical practice points. Conclusions: Forty-four clinical practice points are provided on nutrition assessment, determining energy needs, and nutrient intake in children with AKI and on CKRT based on the existing literature and expert opinions of a multidisciplinary panel.