Protein Requirements for Critically Ill Patients With Renal and Liver Failure. (16th February 2017)

• Record Type: Journal Article
• Authors: Patel, Jayshil J.; McClain, Craig J.; Sarav, Menaka; Hamilton‐Reeves, Jill; Hurt, Ryan T.
• Other Names: McClave Stephen A. guestEditor.; Hurt Ryan T. guestEditor.; Martindale Robert G. guestEditor.; Ochoa Gautier Juan B. guestEditor.
• Is Part Of: Nutrition in clinical practice. Volume 32(2017:Apr.)Supplement 1
• Page Start: 101S
• Page End: 111S
• Publication Date: 2017-02-16
• Subjects: critical care -- acute kidney injury -- acute liver failure -- decompensated liver cirrhosis -- protein requirements -- catabolism -- amino acids -- dietary proteins; Nutrition -- Periodicals; Diet therapy -- Periodicals; Artificial feeding -- Periodicals; 615.854
• DOI: 10.1177/0884533616687501
• Languages: English
• ISSNs: 0884-5336

Abstract

Abstract : Diseases leading to critical illness induce proteolysis resulting in muscle wasting and negative nitrogen balance. Muscle wasting has been associated with poor intensive care unit (ICU)–related outcomes, including an increased risk for mortality. Acute kidney injury (AKI) represents a common organ dysfunction associated with ICU‐related disorders, such as sepsis, trauma, and respiratory failure. AKI and renal replacement therapy lead to amino acid loss. Decompensated liver cirrhosis (DLC) and acute liver failure (ALF) represent more severe forms of liver dysfunction leading to ICU admission. DLC and ALF are associated with proteolysis and amino acid loss. AKI, DLC, and ALF uniquely contribute to negative nitrogen balance. The purpose of this review is to outline proteolysis associated with critical illness; define specific protein abnormalities in AKI, DLC, and ALF; define protein requirements in AKI, DLC, and ALF; and discuss barriers associated with optimal protein supplementation in these disorders.