Scholarlink

Background <p>Acute kidney injury (AKI) is a common and serious complication in critically ill patients, significantly associated with increased mortality. This systematic review and meta-analysis evaluates the impact of protein intake on the incidence of renal adverse events in this population.</p> Methods <p>We included randomized controlled trials (RCTs) comparing higher (&gt; 1.3&#xa0;g/kg/day) versus lower (≤ 1.3&#xa0;g/kg/day) protein intake in adult intensive care patients. PubMed, Embase, and Web of Science were searched from 1980 to April 2025. The risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB2) tool. Random-effects models were used to calculate the pooled odds ratio (OR) with 95% confidence intervals(CI). The primary outcome was renal adverse events, defined as AKI or renal replacement therapy (RRT). Secondary outcomes included 28-day, intensive care unit (ICU), and hospital mortality.</p> Results <p>Fourteen RCTs including 7,280 patients were analyzed. Higher protein intake was associated with a lower risk of renal adverse events (OR 0.86, 95% CI 0.76–0.98; <i>P</i> = 0.02; <i>I</i><sup>2</sup> = 0%). No significant effect was observed on renal replacement therapy (OR 1.20, 95% CI 0.89–1.61; <i>P</i> = 0.23), 28-day mortality (OR 0.76, 95% CI 0.50–1.15; <i>P</i> = 0.19), ICU mortality (OR 0.82, 95% CI 0.62–1.09; <i>P</i> = 0.17), or hospital mortality (OR 0.93, 95% CI 0.65–1.33; <i>P</i> = 0.70). Sensitivity analyses indicated that the renal benefit was largely driven by a single large RCT.</p> Conclusions <p>Protein intake exceeding 1.3&#xa0;g/kg/day is associated with a lower incidence of renal adverse events in critically ill patients, but shows no significant association with a survival advantage. These findings support tailoring protein targets to balance nutritional adequacy against renal burden. Large-scale multicenter trials are needed to establish safe and effective protein thresholds.</p> Registration of systematic reviews <p>The protocol for this meta-analysis was prospectively registered in PROSPERO (CRD420250636693).</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

The impact of protein intake on kidney adverse events in critically Ill patients: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月18日

查看全文
  • Yiyu Hu,
  • Tao Xu,
  • Jiaxin Wei,
  • Penghan Zhu,
  • Di Shi,
  • Jihai Liu

摘要

Background

Acute kidney injury (AKI) is a common and serious complication in critically ill patients, significantly associated with increased mortality. This systematic review and meta-analysis evaluates the impact of protein intake on the incidence of renal adverse events in this population.

Methods

We included randomized controlled trials (RCTs) comparing higher (> 1.3 g/kg/day) versus lower (≤ 1.3 g/kg/day) protein intake in adult intensive care patients. PubMed, Embase, and Web of Science were searched from 1980 to April 2025. The risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB2) tool. Random-effects models were used to calculate the pooled odds ratio (OR) with 95% confidence intervals(CI). The primary outcome was renal adverse events, defined as AKI or renal replacement therapy (RRT). Secondary outcomes included 28-day, intensive care unit (ICU), and hospital mortality.

Results

Fourteen RCTs including 7,280 patients were analyzed. Higher protein intake was associated with a lower risk of renal adverse events (OR 0.86, 95% CI 0.76–0.98; P = 0.02; I2 = 0%). No significant effect was observed on renal replacement therapy (OR 1.20, 95% CI 0.89–1.61; P = 0.23), 28-day mortality (OR 0.76, 95% CI 0.50–1.15; P = 0.19), ICU mortality (OR 0.82, 95% CI 0.62–1.09; P = 0.17), or hospital mortality (OR 0.93, 95% CI 0.65–1.33; P = 0.70). Sensitivity analyses indicated that the renal benefit was largely driven by a single large RCT.

Conclusions

Protein intake exceeding 1.3 g/kg/day is associated with a lower incidence of renal adverse events in critically ill patients, but shows no significant association with a survival advantage. These findings support tailoring protein targets to balance nutritional adequacy against renal burden. Large-scale multicenter trials are needed to establish safe and effective protein thresholds.

Registration of systematic reviews

The protocol for this meta-analysis was prospectively registered in PROSPERO (CRD420250636693).