Energy Balance and Survival in Patients with Acute Renal Failure

Abstract

The metabolic management of acute renal failure (ARF) is an ongoing battle of medical economics. While the nutritional demands of ARF patients are typically elevated with multisystem failure and hemodialysis, fluid restrictions and the stress of frequent dialysis preclude administration of adequate nutrition. Confronted with a dwindling supply and increased demands, these patients utilize body stores to pay the balance. However, as carbohydrate reserves are depleted, more and more endogenous protein must be catabolized to supply the energy requirements. Urea is now generated at a faster rate, requiring more frequent hemodialysis. Administration of nutrition, especially protein, is even further restricted in hopes of minimizing urea generation. It is obvious that this scenario leads down a dark path.