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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Calorie intake and patient outcomes in severe acute kidney injury: Findings from The Randomized Evaluation of Normal vs. Augmented Level of Replacement Therapy (RENAL) study trial
Critical Care, Volume 18, No. 2, Article R45, Year 2014
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Description
Introduction: Current practice in the delivery of caloric intake (DCI) in patients with severe acute kidney injury (AKI) receiving renal replacement therapy (RRT) is unknown. We aimed to describe calorie administration in patients enrolled in the Randomized Evaluation of Normal vs. Augmented Level of Replacement Therapy (RENAL) study and to assess the association between DCI and clinical outcomes.Methods: We performed a secondary analysis in 1456 patients from the RENAL trial. We measured the dose and evolution of DCI during treatment and analyzed its association with major clinical outcomes using multivariable logistic regression, Cox proportional hazards models, and time adjusted models.Results: Overall, mean DCI during treatment in ICU was low at only 10.9 ± 9 Kcal/kg/day for non-survivors and 11 ± 9 Kcal/kg/day for survivors. Among patients with a lower DCI (below the median) 334 of 729 (45.8%) had died at 90-days after randomization compared with 316 of 727 (43.3%) patients with a higher DCI (above the median) (P = 0.34). On multivariable logistic regression analysis, mean DCI carried an odds ratio of 0.95 (95% confidence interval (CI): 0.91-1.00; P = 0.06) per 100 Kcal increase for 90-day mortality. DCI was not associated with significant differences in renal replacement (RRT) free days, mechanical ventilation free days, ICU free days and hospital free days. These findings remained essentially unaltered after time adjusted analysis and Cox proportional hazards modeling.Conclusions: In the RENAL study, mean DCI was low. Within the limits of such low caloric intake, greater DCI was not associated with improved clinical outcomes. © 2014 Bellomo et al.; licensee BioMed Central Ltd.
Authors & Co-Authors
Bellomo, Rinaldo
Australia, Melbourne
Austin Hospital
Cass, Alan
Australia, Sydney
George Institute for International Health
Finfer, Simon R.
Australia, Sydney
Royal North Shore Hospital
Gallagher, Martin P.
Australia, Sydney
George Institute for International Health
Lo, Serigne N.
Australia, Sydney
George Institute for International Health
McArthur, Colin J.
New Zealand, Auckland
Auckland City Hospital
McGuinness, Shay P.
New Zealand, Auckland
Auckland City Hospital
Myburgh, John A.
Australia, Sydney
St George Hospital
Norton, Robyn N.
Australia, Sydney
George Institute for International Health
Nand, Kiran
Australia, Blacktown
Blacktown & Mount Druitt Hospital
Sara, Treena
Australia, Blacktown
Blacktown & Mount Druitt Hospital
Harrigan, Peter W.J.
Australia, Newcastle
John Hunter Hospital
Hardie, Miranda
Australia, Newcastle
John Hunter Hospital
Micallef, Sharon
Australia, Liverpool
Liverpool Hospital
Gresham, Rebecca
Australia, Penrith
Nepean Hospital
Nikas, Maria
Australia, Penrith
Nepean Hospital
Weisbrodt, Leonie
Australia, Penrith
Nepean Hospital
Shehabi, Yahya
Australia, Sydney
Prince of Wales Hospital
Bass, Frances E.
Australia, Sydney
Prince of Wales Hospital
O'Connor, Anne M.
Australia, Sydney
Royal North Shore Hospital
Rajbhandari, Dorrilyn
Australia, Sydney
Royal Prince Alfred Hospital
Buhr, Heidi
New Zealand, Auckland
Auckland City Hospital
Parke, Rachael L.
New Zealand, Auckland
Auckland City Hospital
Newby, Lynette
New Zealand, Auckland
Auckland City Hospital
Henderson, Seton J.
New Zealand, Christchurch
Christchurch Hospital new Zealand
Mehrtens, Jan E.
New Zealand, Christchurch
Christchurch Hospital new Zealand
Joyce, Christopher John
Australia, Woolloongabba
Princess Alexandra Hospital
Lipman, Jeffrey
Australia, Brisbane
Royal Brisbane and Women's Hospital
Fourie, Cheryl
Australia, Brisbane
Royal Brisbane and Women's Hospital
Lassig-Smith, Melissa M.
Australia, Brisbane
Royal Brisbane and Women's Hospital
Rivett, Justine
Australia, Adelaide
Royal Adelaide Hospital
Edington, John P.
Australia, Bendigo
Bendigo Hospital
Boschert, Catherine
Australia, Bendigo
Bendigo Hospital
Smith, Julie C.
Australia, Bendigo
Bendigo Hospital
Orford, Neil R.
Australia, Geelong
Geelong Hospital
Elderkin, Tania D.
Australia, Geelong
Geelong Hospital
Fraser, Melissa
Australia, Geelong
Geelong Hospital
Galt, Pauline
Australia, Clayton
Monash Medical Centre
Barge, Deborah K.
Australia, Melbourne
Royal Melbourne Hospital
Holmes, Jennifer A.
Australia, Fitzroy
St. Vincent's Hospital Melbourne
Smith, Roger J.
Australia, Fitzroy
St. Vincent's Hospital Melbourne
Davies, Andrew R.
Australia, Melbourne
The Alfred
Murray, Lynnette J.
Australia, Melbourne
The Alfred
Vallance, Shirley A.
Australia, Melbourne
The Alfred
French, Craig J.
Australia, Footscray
Western Hospital
Little, Lorraine
Australia, Footscray
Western Hospital
Palermo, Anne Marie
Australia, Fremantle
Fremantle Hospital
Dobb, Geoffrey J.
Australia, Perth
Royal Perth Hospital
Boardman, Melanie
Australia, Perth
Royal Perth Hospital
Statistics
Citations: 40
Authors: 49
Affiliations: 31
Identifiers
Doi:
10.1186/cc13767
ISSN:
13648535
Research Areas
Health System And Policy
Violence And Injury
Study Design
Randomised Control Trial
Case-Control Study
Study Approach
Quantitative