Trial reportCritical care (London, England)2014
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.
Trial report in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00221013 (Multicentre, Unblinded, Open Label, Randomised, Controlled Trial to Assess the Effect of Augmented Vs. Normal Continuous Renal Replacement Therapy), which is not on this map. Cited by 19 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Multicentre, Unblinded, Open Label, Randomised, Controlled Trial to Assess the Effect of Augmented Vs. Normal Continuous Renal Replacement Therapy (CRRT) on 90-Day All-Cause Mortality of Intensive Care Unit Patients With Severe Acute Renal Failure (ARF).
Who cites it
19 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Timing of kidney replacement therapy initiation for acute kidney injury.The Cochrane database of systematic reviews · 2022Pooled it
- Nutrition support for acute kidney injury 2020-consensus of the Taiwan AKI task force.Journal of the Chinese Medical Association : JCMA · 2022Pooled it
- Non-pharmacological interventions for preventing clotting of extracorporeal circuits during continuous renal replacement therapy.The Cochrane database of systematic reviews · 2021Pooled it
- Protein-Energy Wasting Assessment and Clinical Outcomes in Patients with Acute Kidney Injury: A Systematic Review with Meta-Analysis.Nutrients · 2020Pooled it
- Timing of renal replacement therapy initiation for acute kidney injury.The Cochrane database of systematic reviews · 2018Pooled it
- Lower versus higher dose of enteral caloric intake in adult critically ill patients: a systematic review and meta-analysis.Critical care (London, England) · 2016Pooled it
- Intensity of continuous renal replacement therapy for acute kidney injury.The Cochrane database of systematic reviews · 2016Pooled it
- Influence of kidney replacement therapy on indirect calorimetry in critically ill patients.European journal of clinical nutrition · 2025Observational
- Professor Rinaldo Bellomo: Founder, architect, and choreographer of critical care nephrology.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2025Review
- Evaluation of nutritional intake and malnutrition in critically ill patients and its relationship with 28-day death.Scientific reports · 2025Observational
- Metabolic and nutritional aspects in continuous renal replacement therapy.Journal of intensive medicine · 2023Review
- Impact of Developing Dialysis-Requiring Acute Kidney Injury on Long-Term Mortality in Cancer Patients with Septic Shock.Cancers · 2023Article
- The prognostic effects of the geriatric nutritional risk index on elderly acute kidney injury patients in intensive care units.Frontiers in medicine · 2023Article
- Article
- When timing and dose of nutrition support were examined, the modified Nutrition Risk in Critically Ill (mNUTRIC) score did not differentiate high-risk patients who would derive the most benefit from nutrition support: a prospective cohort study.Annals of intensive care · 2018Article
- Observational
- Effect of Calories Delivered on Clinical Outcomes in Critically Ill Patients: Systemic Review and Meta-analysis.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2017Article
- Metabolic and nutritional support of critically ill patients: consensus and controversies.Critical care (London, England) · 2015Review
- The nutritional energy to clinical outcome relation revisited.Critical care (London, England) · 2014Article
Corrections and comments
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionCurrent 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.
methodsWe 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.
resultsOverall, 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.
conclusionsIn the RENAL study, mean DCI was low. Within the limits of such low caloric intake, greater DCI was not associated with improved clinical outcomes.
trial registrationClinicalTrials.gov number, NCT00221013.
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