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Protein-calorie malnutrition is an important independent predictor of in-hospital mortality in patients with AKI. In a prospective study of 300 AKI patients, 42% presented with signs of severe malnutrition on admission.151
The nutritional management of AKI patients must consider the metabolic derangements and proinflammatory state associated with renal failure, the underlying disease process and comorbidities, as well as the derangements in nutrient balance caused by RRT. Very few systematic studies have assessed the impact of nutrition on clinical end-points used in these guidelines (i.e., mortality, need for RRT, and incidence of AKI). Recommendations are therefore largely based on expert opinion. Several expert panels have developed clinical practice guidelines for the nutritional management of patients with AKI, whether treated with or without RRT.152-156 A recent narrative review has also provided updated information on this topic.157
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