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Daily Protein Intake and Patient Outcomes in Severe Acute Kidney Injury: Findings of the Randomized Evaluation of Normal versus Augmented Level of Replacement Therapy (RENAL) Trial

Bellomo, R., Cass, Alan, Cole, L., Finfer, S., Gallagher, M., Lee, J., Lo, S., McArthur, C., McGuinness, S., Norton, R., Myburgh, J., Sheinkestel, C. and The RENAL Study Investigators (2014). Daily Protein Intake and Patient Outcomes in Severe Acute Kidney Injury: Findings of the Randomized Evaluation of Normal versus Augmented Level of Replacement Therapy (RENAL) Trial. Blood Purification,37(4):325-334.

Document type: Journal Article
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IRMA ID 84473293xPUB40
Title Daily Protein Intake and Patient Outcomes in Severe Acute Kidney Injury: Findings of the Randomized Evaluation of Normal versus Augmented Level of Replacement Therapy (RENAL) Trial
Author Bellomo, R.
Cass, Alan
Cole, L.
Finfer, S.
Gallagher, M.
Lee, J.
Lo, S.
McArthur, C.
McGuinness, S.
Norton, R.
Myburgh, J.
Sheinkestel, C.
The RENAL Study Investigators
Journal Name Blood Purification
Publication Date 2014
Volume Number 37
Issue Number 4
ISSN 0253-5068   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84906592862
Start Page 325
End Page 334
Total Pages 10
Place of Publication Switzerland
Publisher S. Karger AG
HERDC Category C1 - Journal Article (DIISR)
Abstract Background and Aims: We aimed to examine the association between daily protein intake (DPI) and outcomes in patients from the Randomized Evaluation of Normal versus Augmented Level (RENAL) trial. Methods: We analyzed the association between DPI and clinical outcomes using multivariable logistic regression, Cox proportional hazards models and time-adjusted analysis.

Results:
During ICU stay, mean DPI was 37.6 g/day among survivors and 37.7 g/day among nonsurvivors (p = 0.96; DPI of 0.5 g/kg/day). Only 159 (10.9%) of the patients received a mean DPI of >1 g/kg. Patients with a DPI above the median had a 43.1% mortality compared with 46.1% for a DPI below the median (p = 0.25). On multivariate analysis, a lower DPI was not associated with increased odds ratios for 90-day mortality or any secondary outcomes. Cox proportional hazards models and time-adjusted analysis confirmed these findings.

Conclusions:
In the RENAL study, mean DPI was low. Within the confines of such low DPI, greater amounts of DPI were not independently associated with improved clinical outcomes. Video Journal Club “Cappuccino with Claudio Ronco” at www.karger.com/?doi=363175.
Keywords Protein intake
Acute kidney injury
Hemofiltration
Nitorgen balance
Nutrition
DOI http://dx.doi.org/10.1159/000363175   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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Created: Wed, 19 Aug 2015, 12:31:44 CST