Nutritional support in critical patients with acute kidney injury        ZHAO Yun-zhao. Research Institute of General Surgery, Nanjing General Hospital of Nanjing Military Command, People’s Liberation Army, Medical College of Nanjing University, Nanjing 210002, China
Abstract    Acute kidney injury(AKI) is a frequent complication affecting many ICU patients and is associated with increased morbidity and mortality. AKI often occurs in conjunction with critical illness, which is a hypermetabolic state presenting with hyperglycemia, insulin resistance, hypertriglyceridemia and increased protein catabolism. In addition to addressing above changes, the clinician should evaluate the important nutrition implications of decreased kidney function which include vitamins, electrolytes, minerals, trace elements and the presence and type of renal replacement therapy. Optimal nutrition management in AKI includes providing adequate macronutrient support to correct underlying conditions and prevent ongoing loss, supplementing micronutrients and vitamins during renal replacement therapy, and adjusting electrolyte replacement based on the degree and extent of renal dysfunction.