Nutritional aspects in acute kidney injury

Berbel, Marina Nogueira; Pinto, Milene Peron Rodrigues; Ponce, Daniela; Balbi, André Luís

doi:10.1016/s0104-4230(11)70118-x

Cited by 7 publications

(7 citation statements)

References 29 publications

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“…Almost half of adult patients with AKI have severe malnutrition on admission to the ICU (6). Physiologic changes due to AKI cause derangements in substrate metabolism and body composition (8), leading to hypercatabolism (9), hypoalbuminemia, loss of lean body mass, and depletion of adipose tissue, even with adequate ingestion of nutrients (10). Muscle protein catabolism and atrophy occur as a result of coexisting systemic inflammation, oxidative stress, insulin resistance, and metabolic acidosis (11).…”

Section: Introductionmentioning

confidence: 99%

Nutrition Support among Critically Ill Children with AKI

Kyle

Akcan-Arikan

Orellana

et al. 2013

Clinical Journal of the American Society of Nephrology

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SummaryBackground Critically ill children are at high risk of underfeeding and AKI, which may lead to further nutritional deficiencies. This study aimed to determine the adequacy of nutrition support during the first 5 days of intensive care unit (ICU) stay. Results Of the 167 patients, 102 were male and 65 were female (median age 1.4 years). Using the RIFLE criteria, 102 (61%) patients had no AKI, whereas 44 (26%) were classified as category R (risk), 12 (7%) as category I (injury), and 9 (5%) as category F (failure). The median 5-day energy intake was lower relative to estimated BMR. Overall protein provision (19%) was lower than energy provision (55%) compared with estimated needs (P,0.001). I/F patients were more likely to be fasted versus receiving enteral/parenteral nutrition (n=813 patient days) and to receive ,90% of BMR (n=832 patient days) than No AKI/R patients.Conclusions Underfeeding, common in critically ill children, was accentuated in AKI. Protein underfeeding was greater than energy underfeeding in the first 5 days of PICU stay. Efforts should be made to provide adequate nutrition in ICU patients with AKI.

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Section: Introductionmentioning

confidence: 99%

Nutrition Support among Critically Ill Children with AKI

Kyle

Akcan-Arikan

Orellana

et al. 2013

Clinical Journal of the American Society of Nephrology

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“…This suggests SCr as a biomarker of AKI may become less useful as cancer treatment progresses, possibly due to loss of muscle mass as cancer treatment progresses or due to a chronic poor nutritional state leading to lower muscle mass and impaired kidney repair processes (41). Future research should consider evaluating other AKI biomarkers (e.g., cystatin C) to assess AKI more accurately and evaluate associations between biomarkers and clinical outcomes (e.g., mortality, long-term kidney outcomes).…”

Section: Discussionmentioning

confidence: 99%

“…The proportion of patients with SCr-AKI at the late visit was lower compared with the early visit; however, there may be subclinical kidney injury (without a rise in SCr) at the late visit. This suggests SCr as a biomarker of AKI may become less useful as cancer treatment progresses, possibly due to loss of muscle mass as cancer treatment progresses or due to a chronic poor nutritional state leading to lower muscle mass and impaired kidney repair processes (41). Future research should consider evaluating other AKI biomarkers ( e.g.…”

Section: Discussionmentioning

confidence: 99%

Urine Neutrophil Gelatinase-Associated Lipocalin and Kidney Injury Molecule-1 to Detect Pediatric Cisplatin-Associated Acute Kidney Injury

et al. 2022

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Background: Few studies have described associations between acute kidney injury (AKI) biomarkers, urinary neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1), and AKI in cisplatin-treated children. We aimed to describe excretion patterns of urine NGAL and KIM-1 and associations with AKI in children receiving cisplatin. Methods: Participants (n=159) were enrolled between 2013 and 2017 in a prospective cohort study conducted in 12 Canadian pediatric hospitals. Participants were evaluated at early cisplatin infusions (at first or second cisplatin cycle) and late cisplatin infusions (last or second-to-last cycle). Urine NGAL and KIM-1 were measured (1) pre-cisplatin infusion, (2) post-infusion (morning after), and (3) at hospital discharge at early and late cisplatin infusions. Primary outcome: AKI defined by serum creatinine rise within 10 days post-cisplatin based on Kidney Disease: Improving Global Outcomes guidelines criteria (≥stage 1). Results: Of 159 children, 156 (median [interquartile (IQR)] age: 5.8 [2.4-12.0] years; 78 [50%] female) had biomarker data available at early cisplatin infusions and 127 had data at late infusions. Forty-six of 156 (29%) and 22/127 (17%) developed AKI within 10 days of cisplatin administration following early and late infusions, respectively. Urine NGAL and KIM-1 concentrations were significantly higher in patients with vs. without AKI (near hospital discharge of late cisplatin infusion, median [IQR]: NGAL: 76.1 [10.0-232.7] vs. 14.9 [5.4-29.7] ng/mg creatinine; KIM-1: 4415 [2083-9077] vs. 1049 [358-3326] pg/mg creatinine; P<.01). These markers modestly discriminated for AKI (area under receiver-operating characteristic curve (AUC-ROC) range: NGAL: 0.56-0.72; KIM-1: 0.48-0.75). Biomarker concentrations were higher and better discriminated for AKI at late cisplatin infusions (AUC-ROCs range: 0.54-0.75) vs. early infusions (AUC-ROCs range: 0.48-0.65). Conclusions: Urine NGAL and KIM-1 were modest at discriminating for cisplatin-associated AKI. Further research is needed to determine clinical utility and applicability of these markers and late kidney outcomes associations.

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“…However, the best tool to identify patients at high risk of malnutrition is still in dispute. Single nutrition indicators are often affected by many factors [ 25 ]. Subjective comprehensive nutritional scoring systems like Subjective Global Assessment (SGA), are sophisticated, which need the assistance of specialized nutritionists.…”

Section: Discussionmentioning

confidence: 99%

Nutritional status and risk of contrast-associated acute kidney injury in elderly patients undergoing percutaneous coronary intervention

et al. 2021

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Background This study aimed to investigate the connection between malnutrition evaluated by the Controlling Nutritional Status (CONUT) score and the risk of contrast-associated acute kidney injury (CA-AKI) in elderly patients who underwent percutaneous coronary intervention (PCI). Methods A total of 1308 patients aged over 75 years undergoing PCI was included. Based on the CONUT score, patients were assigned to normal (0–1), mild malnutrition (2–4), moderate-severe malnutrition group (≥ 5). The primary outcome was CA-AKI (an absolute increase in ≥ 0.3 mg/dL or ≥ 50% relative serum creatinine increase 48 h after contrast medium exposure). Results Overall, the incidence of CA-AKI in normal, mild, moderate-severe malnutrition group was 10.8%, 11.0%, and 27.2%, respectively (p < 0.01). Compared with moderate-severe malnutrition group, the normal group and the mild malnutrition group showed significant lower risk of CA-AKI in models adjusting for risk factors for CA-AKI and variables in univariate analysis (odds ratio [OR] = 0.48, 95% confidence interval [CI]: 0.26–0.89, p = 0.02; OR = 0.46, 95%CI: 0.26–0.82, p = 0.009, respectively). Furthermore, the relationship were consistent across the subgroups classified by risk factors for CA-AKI except anemia. The risk of CA-AKI related with CONUT score was stronger in patients with anemia. (overall interaction p by CONUT score = 0.012). Conclusion Moderate-severe malnutrition is associated with higher risk of CA-AKI in elderly patients undergoing PCI.

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Nutritional aspects in acute kidney injury

Cited by 7 publications

References 29 publications

Nutrition Support among Critically Ill Children with AKI

Nutrition Support among Critically Ill Children with AKI

Urine Neutrophil Gelatinase-Associated Lipocalin and Kidney Injury Molecule-1 to Detect Pediatric Cisplatin-Associated Acute Kidney Injury

Nutritional status and risk of contrast-associated acute kidney injury in elderly patients undergoing percutaneous coronary intervention

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