Dietary management in acute kidney injury

Acute kidney injury (AKI) is recognized as a systemic inflammatory syndrome, a pro-oxidative, proinflammatory, and hypermetabolic state exerting a profound impact on the course of the disease that is associated with AKI. Despite advances in intensive care and dialytic technology, the mortality rate for AKI still remains high. Nutritional and metabolic management present a cornerstone in the care of these patients. Since, patients with AKI are at high-risk for developing malnutrition as a result of coexisting catabolic illness, therefore, protein-calorie wasting (PCW) is an important factor which influences the outcome of AKI. In fact, AKI is associated with specific changes in protein, carbohydrate, and lipid metabolism, combining together to cause a general disruption of the ‘internal milieu’: catabolism of skeletal muscle proteins with increased amino acid turnover and negative nitrogen balance, hyperglycaemia, and insulin resistance, altered lipid metabolism, water, electrolyte, and acid-base metabolism unbalances.