Special issues in the patient with renal failure

Kapadia, Farhad; Bhojani, Kaushik; Shah, Bharat

doi:10.1016/s0749-0704(02)00055-6

Cited by 15 publications

(18 citation statements)

References 44 publications

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“…Others studies agree with our results that suggest the hypermetabolism may be present in AKI patients since AKI is a part of a more complex illness such as sepsis and not necessarily the direct consequence of renal failure per se suggesting that AKI does not influence the energy metabolism of septic patients [16][17][18][19][20][21].…”

Section: Discussionsupporting

confidence: 92%

“…In contrast, a hypermetabolic state was frequently observed in AKI patients and associated with its cause and severity [15]. The hypermetabolism may be present in AKI patients since AKI is a part of a more complex illness such as sepsis and not necessarily the direct consequence of renal failure per se [15][16][17][18][19][20][21]. Thus, it is unknown whether possible changes in energy metabolism observed in septic AKI patients are directly related to AKI itself.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of energy metabolism in septic patients with and without AKI

Sanches

Góes

Bufarah

et al. 2017

Nutrire

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Background: The determination of resting energy expenditure (REE) in critically ill patients could prevent complications such as hypo-and hyperalimentation. This study aims to describe the REE in septic patients with and without acute kidney injury (AKI) and compare the REE estimated by the Harris-Benedict equation (HB) with the REE measured by indirect calorimetry (IC). Methods: Prospective and observational study was performed. Septic patients older than 18 years, undergoing mechanical ventilation, with or without AKI defined by KDIGO criteria, and admitted to the Intensive Care Unit of University Hospital from Brazil were included. The REE was estimated by HB equation and measured by the IC within 72 h after the diagnosis of sepsis and 7 days after the initial measure. Results: Sixty-eight patients were evaluated, age was 62.5 ± 16.6 years, 64.7% were male, 63.2% had AKI, and SOFA was 9.8 ± 2.35. The measured REE was 1857.5 ± 685.32 kcal, while the estimated REE was 1514.8 ± 356.72 kcal, with adequacy of 123.5 ± 43%. Septic patients without AKI (n = 25) and with AKI (n = 43) had measured REE statistically higher than the estimated one Conclusions: The REE measured by IC was significantly higher than that estimated by HB equation in both septic with and without AKI. There was no significant difference in REE between the septic patients with and without AKI, suggesting that AKI does not influence the energy metabolism of septic patients.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Evaluation of energy metabolism in septic patients with and without AKI

Sanches

Góes

Bufarah

et al. 2017

Nutrire

View full text Add to dashboard Cite

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“…Patients with hypertension, cardiac and vascular disease, diabetes mellitus, or advanced age are a high-risk group because of common preexisting renal impairment (37,38). For these reasons, hemodynamic changes are probably more consistent and more frequent than in noncardiac surgery.…”

Section: Arf After Cardiac Surgerymentioning

confidence: 99%

Renal ultrasonography in critically ill patients

Barozzi

Valentino

Santoro

et al. 2007

Critical Care Medicine

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Acute renal failure is a sudden and sustained decrease in the glomerular filtration rate associated with a loss of excretory function and the accumulation of metabolic waste products and water. It leads to an increase in serum urea and creatinine, usually with a decrease in urine output. Although routine surveillance of patients by means of laboratory examinations has been well defined, very little is known about renal imaging. Modern technology has provided a large number of sophisticated monitoring systems. Ultrasonography with color-Doppler study of the kidneys may be indicated as a possible monitor of renal perfusion. Ultrasonography is often used as the initial imaging procedure in the examination of patients with renal failure. Aside from excluding hydronephrosis, it is well recognized in characterizing the type of renal disease, especially in an acute setting. This article describes the use of ultrasound to achieve the proper diagnosis of acute renal diseases and to enable the appropriate and early assessment of these patients in intensive care units.

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“…These effects, in turn, lead to a negative nitrogen balance, hyperglycemia, and hypertriglyceridemia. [1][2]6,10 The kidneys play a major role in regulating fluid, electrolyte, and acid-base balance. In ARF, significant imbalances in fluid, electrolytes, and acid-base may occur.…”

Section: Metabolic and Nutritional Aspects Of Arfmentioning

confidence: 99%

Metabolic and Nutritional Aspects of Acute Renal Failure in Critically Ill Patients Requiring Continuous Renal Replacement Therapy

2005

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Acute renal failure (ARF) is rarely an isolated process but is often a complication of underlying conditions such as sepsis, trauma, and multiple-organ failure in critically ill patients. As such, concomitant clinical conditions significantly affect patient outcome. Poor nutritional status is a major factor in increasing patients' morbidity and mortality. Malnutrition in ARF patients is caused by hypercatabolism and hypermetabolism that parallel the severity of illness. When dialytic intervention is indicated, continuous renal replacement therapy (CRRT) is a commonly used alternative to intermittent hemodialysis because it is well tolerated by hemodynamically unstable patients. This paper reviews the metabolic and nutritional alterations associated with ARF and provides recommendations regarding the nutritional, fluid, electrolyte, micronutrient, and acid-base management of these patients. The basic principles of CRRT are addressed, along with their nutritional implications in critically ill patients. A patient case is presented to illustrate the clinical application of topics covered within the paper.

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Special issues in the patient with renal failure

Cited by 15 publications

References 44 publications

Evaluation of energy metabolism in septic patients with and without AKI

Evaluation of energy metabolism in septic patients with and without AKI

Renal ultrasonography in critically ill patients

Metabolic and Nutritional Aspects of Acute Renal Failure in Critically Ill Patients Requiring Continuous Renal Replacement Therapy

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