Early protein delivery in critically ill patients with acute kidney injury: post hoc analysis of a multicenter cluster-randomized controlled trial

• Published in: Burns and trauma 2024, Vol.12, p.tkae027
• Main Authors: Lv, Cheng, Zhou, Lingliang, Zhou, Yufeng, Lew, Charles Chin Han, Lee, Zheng-Yii, Hasan, M Shahnaz, Li, Baiqiang, Liu, Yang, Lin, Jiajia, Mao, Wenjian, Stoppe, Christian, van Zanten, Arthur Raymond Hubert, Li, Weiqin, Liu, Yuxiu, Ke, Lu
• Format: Article
• Language: English
• Subjects: Kidneys; Mortality; Proteins
• ISSN: 2321-3868; 2321-3876; 2321-3876
• DOI: 10.1093/burnst/tkae027

There is controversy over the optimal early protein delivery in critically ill patients with acute kidney injury (AKI). This study aims to evaluate whether the association between early protein delivery and 28-day mortality was impacted by the presence of AKI in critically ill patients. This is a analysis of data from a multicenter cluster-randomised controlled trial enrolling newly admitted critically ill patients (n = 2772). Participants without chronic kidney disease and with complete data concerning baseline renal function were included in this study. The primary outcome was 28-day mortality. Cox proportional hazards models were used to analyze the association between early protein delivery, reflected by mean protein delivery from day 3-5 after enrollment, 28-day mortality and whether baseline AKI stages interacted with this association. Overall, 2552 patients were included, among whom 567 (22.2%) had AKI at enrollment (111 stage I, 87 stage II, 369 stage III). Mean early protein delivery was 0.60 ± 0.38 g/kg/day among the study patients. In the overall study cohort, each 0.1 g/kg/day increase in protein delivery was associated with a 5% reduction in 28-day mortality[hazard ratio (HR) = 0.95; 95% confidence interval (CI) 0.92-0.98,