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In children with AKI, physiological macronutrient requirements are age-dependent, reflecting the developmental dynamics of growth and metabolism. Research exploring nutritional requirements in children with critical illness and AKI is limited to observational studies. With respect to calorie provision, it is generally agreed that critically ill children, like adults, should receive 100–130% of the basal energy expenditure, which can be estimated with acceptable precision and accuracy by the Caldwell-Kennedy equation179: (resting energy expenditure [kcal/kg/d] = 22 + 31.05 x weight [kg] + 1.16 x age [years]).
In a recent survey of the nutritional management of 195 children with AKI on CRRT, the maximal calorie prescription in the course of treatment averaged 53, 31, and 21 kcal/kg/d, and that for protein intake 2.4, 1.9, and 1.3 g/kg/d in children aged < 1, 1–13, and > 13 years, respectively.180 Although not validated by outcome studies, these figures provide an orientation for the macronutrient supply typically achieved in and tolerated by children with AKI receiving CRRT.
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