Acute renal failure is a disorder in which the kidneys suddenly stop functioning, leading to the accumulation of nitrogenous wastes. Causes include autoimmune kidney disease, surgery, septic shock, dehydration, hypertension and other infections that directly affect the kidneys. Treatment options may differ depending on the cause of the renal failure. Protein, calorie and fluids needs are highly individualized depending on your specific condition.
Calorie Needs
Energy requirements for acute renal failure patients can generally be met by providing 30 to 35 calories per kilogram of ideal body weight. Women who are 5 feet tall have an ideal body weight of 100 lbs., with each additional inch above 5 feet allowing for 5 lbs. Men who are 5 feet tall have an ideal body weight of 106 lbs. with each additional inch above 5 feet allowing for 6 lbs. The upper range of the calorie needs is for individuals who are experiencing trauma, metabolic stress and disease.
Protein Needs
If you are not going to receive any dialysis therapy for your acute renal failure, protein needs are 0.6 to 1.0 g per kilogram of body weight. Protein sources with both essential and nonessential amino acids should be consumed. If you are going to need dialysis, your protein needs can be as high as 1.4 g per kilogram body weight. Acceptable protein foods include meat, poultry, eggs, milk, beans, nuts and nut butters.
Fluid Needs
Fluid needs for acute renal failure patients are generally 500 ml plus your 24-hour urine output. Fluid needs also depend on whether you are oliguric or anuric. Oliguria refers to urine output between 50 and 400 ml. Anuria is urine ouput less than 50 ml. Fluid balance needs to be monitored to avoid overhydration and electrolyte disorders. You will most likely need to have your fluid intake and output measured daily. When on a fluid restriction, beverages that are less sweet will quench your thirst. Fluids such as water and juice are acceptable. Only drink when you are thirsty if you are on a fluid restriction. Soups, ice cream and yogurt are all foods that also count as fluids.
Vitamin and Minerals
The vitamin and mineral requirements for patients with acute renal failure are not currently known. Vitamin A levels may be increased in these patients, and therefore supplementation of vitamin A should be avoided. Vitamin D and vitamin K levels may be low in acute renal failure patients. Deficiencies may also occur with the water-soluble vitamins except for vitamin C, so vitamin C supplementation should be limited.
References
- Medline Plus: Acute Kidney Failure
- "Nutrition Therapy and Pathophysiology"; Marcia Nelms, et al.; 2007.
- The Merck Manuals Online Medical Library: Acute Renal Failure
