PDF(Pubmed)
Abstract：
Most randomized controlled studies on nutrition in intensive care patients did not yield conclusive results or were neutral or negative concerning the primary endpoints but also in most secondary endpoints. However, there is a consistent observation that in several of these studies there was a negative effect of the nutrition intervention on the kidneys in one of the study arms. During the early phase and in unstable periods during further course of disease an inadequate clinical nutrition can damage the kidneys, can elicit or aggravate acute kidney injury and/ or increase requirements of renal replacement therapy (RRT). This relates to total energy intake, glucose intake/hyperglycemia and protein/ amino acid intake at various stages of renal dysfunction. The kidney could present a critical organ system for guiding nutrition therapy, a close monitoring of kidney function should be observed and nutrition therapy may need to be adapted accordingly. The long-held dogma of performing full nutrition and accept an otherwise not necessary RRT is definitely to be refuted.
摘要：
大多数关于重症监护患者营养的随机对照研究没有得出结论性的结果，或者关于主要终点以及大多数次要终点都是中性或阴性的。然而,有一个一致的观察结果是，在这些研究中的几项研究中，营养干预对其中一个研究组的肾脏产生了负面影响。在疾病的早期和不稳定期，临床营养不足会损害肾脏，可引起或加重急性肾损伤和/或增加肾脏替代疗法（RRT）的需求。这与总能量摄入有关，肾功能不全不同阶段的葡萄糖摄入/高血糖和蛋白质/氨基酸摄入。肾脏可以提供指导营养治疗的关键器官系统，应密切监测肾功能，营养治疗可能需要相应调整。执行充分营养并接受其他不必要的RRT的长期教条肯定会被驳斥。
