Kidney Week

Abstract: SA-PO0880

Effect of Protein-Calorie Malnutrition on Clinical Outcomes in Patients with AKI on CKRT: A Secondary Analysis of a Prospective Cohort Study

Session Information

• Health Maintenance, Nutrition, and Metabolism
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1500 Health Maintenance, Nutrition, and Metabolism

Authors

• Trakarnvanich, Thanphisit, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Thailand

Thanphisit Trakarnvanich, MD

• Ostermann, Marlies, Guy's and St Thomas' NHS Foundation Trust, London, England, United Kingdom

Marlies Ostermann, MD, PhD

• Phannajit, Jeerath, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Thailand

Jeerath Phannajit, MD

• Wannakittirat, Anyarin, Naraesuan University Hospital, Phitsanulok, Thailand

Anyarin Wannakittirat, MD

• Kittiskulnam, Piyawan, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Thailand

Piyawan Kittiskulnam, MD

• Kulvichit, Win, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Thailand

Win Kulvichit, MD

• Faisatjatham, Surasak, Khon Kaen University Faculty of Medicine, Khon Kaen, Thailand

Surasak Faisatjatham, MD

• Peerapornratana, Sadudee, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Thailand

Sadudee Peerapornratana, MD

• Avihingsanon, Yingyos, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Thailand

Yingyos Avihingsanon, MD

• Srisawat, Nattachai, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Thailand

Nattachai Srisawat, MD

• Lumlertgul, Nuttha, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Thailand

Nuttha Lumlertgul, MD, PhD

Background

Evidence on the impact of nutritional support in critically ill patients with acute kidney injury (AKI) receiving continuous renal replacement therapy (CRRT) is limited

Methods

This secondary analysis of the prospective VExLUS-RRT study (NCT06254703) included adult ICU patients with AKI requiring CRRT at King Chulalongkorn Memorial Hospital (March 2024–November 2025). Nutritional intake from enteral, parenteral, and non-nutritional sources (glucose solutions, propofol, citrate) was recorded daily. Effluent urea nitrogen was used to estimate normalized protein catabolic rate (nPCR). The primary outcome was 28-day mortality

Results

Among 100 patients, median age was 67 years, 58% were male, and median BMI was 23.2 kg/m2. Non-survivors had lower calorie intake [15.8 vs 24.8 kcal/kg/day; p=0.001] and protein intake [0 vs 0.72 g/kg/day; p=0.002] than survivors. A J-shaped relationship was observed between protein intake and mortality. Patients receiving <0.08 g/kg/day had the highest mortality (adjusted HR 7.43, 95% CI 2.60–21.23; p<0.001). However, intake >0.83 g/kg/day was not associated with improved survival compared with moderate intake (0.47–0.83 g/kg/day). Protein intake showed a weak correlation with nPCR (r=0.154, p<0.001) but not with BUN/Cr ratio

Conclusion

In AKI patients on CRRT, inadequate energy and protein intake is associated with higher mortality, while higher protein intake does not improve survival. Adequate early nutritional support appears essential and warrants further study

Acknowledgment

The authors would like to thank ICU team, research nurses and fellows for their assistance in conducting this study.