Work

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

Year: 2025

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: 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: = 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).

Source: International Urology and Nephrology

DOI: 10.1007/s11255-025-04958-5

Authors: Yiyu Hu, Tao Xu, Jiaxin Wei, Penghan Zhu, Di Shi, Jihai Liu

Institutions: Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital, Institute of Basic Medical Sciences of the Chinese Academy of Medical Sciences

Language: English

Topic: Acute Kidney Injury Research

Subfield: Nephrology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,690