Enteral nutrition in patients with acute renal failure

Enteral nutrition in patients with acute renal failure. Background Systematic studies on safety and efficacy of enteral nutrition in patients with acute renal failure (ARF) are lacking. Methods We studied enteral nutrition–related complications and adequacy of nutrient administration during 2525days of artificial nutrition in 247 consecutive patients fed exclusively by the enteral route: 65 had normal renal function, 68 had ARF not requiring renal replacement therapy, and 114 required renal replacement therapy. Results No difference was found in gastrointestinal or mechanical complications between ARF patients and patients with normal renal function, except for high gastric residual volumes, which occurred in 3.1% of patients with normal renal function, 7.3% of patients with ARF not requiring renal replacement therapy, 13.2% of patients with ARF on renal replacement therapy ( P = 0.02 for trend), and for nasogastric tube obstruction: 0.0%, 5.9%, 14%, respectively ( P P = 0.09 for trend). At regimen, mean delivered nonprotein calories were 19.8 kcal/kg (SD 4.6), 22.6 kcal/kg (8.4), 23.4 kcal/kg (6.5); protein intake was 0.92g/kg (0.21), 0.87g/kg (0.25), and 0.92g/kg (0.21), the latter value being below that currently recommended for ARF patients on renal replacement therapy. Median fluid intake with enteral nutrition was 1440mL (range 720 to 1960), 1200 (720 to 2400), and 960 (360 to 1920). Conclusion Enteral nutrition is a safe and effective nutritional technique to deliver artificial nutrition in ARF patients. Parenteral aminoacid supplementation may be required, especially in patients with ARF needing renal replacement therapy.