title: Daily protein intake and patient outcomes in severe acute kidney injury: findings of the randomized evaluation of normal versus augmented level of replacement therapy (RENAL) trial.
abstract: OBJECTIVE
  We aimed to examine the association between daily protein intake (DPI) and outcomes in patients from the Randomized Evaluation of Normal versus Augmented Level (RENAL) trial.
  
  
  METHODS
  We analyzed the association between DPI and clinical outcomes using multivariable logistic regression, Cox proportional hazards models and time-adjusted analysis.
  
  
  RESULTS
  During ICU stay, mean DPI was 37.6 g/day among survivors and 37.7 g/day among nonsurvivors (p = 0.96; DPI of 0.5 g/kg/day). Only 159 (10.9%) of the patients received a mean DPI of >1 g/kg. Patients with a DPI above the median had a 43.1% mortality compared with 46.1% for a DPI below the median (p = 0.25). On multivariate analysis, a lower DPI was not associated with increased odds ratios for 90-day mortality or any secondary outcomes. Cox proportional hazards models and time-adjusted analysis confirmed these findings.
  
  
  CONCLUSIONS
  In the RENAL study, mean DPI was low. Within the confines of such low DPI, greater amounts of DPI were not independently associated with improved clinical outcomes. Video Journal Club "Cappuccino with Claudio Ronco" at www.karger.com/?doi=363175.
authors.affiliation: Austin Hospital, Heidelberg, Vic., Australia.
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Bellomo
authors.forename: Alan
authors.initials: A
authors.lastname: Cass
authors.forename: Louise
authors.initials: L
authors.lastname: Cole
authors.forename: Simon
authors.initials: S
authors.lastname: Finfer
authors.forename: Martin
authors.initials: M
authors.lastname: Gallagher
authors.forename: Joanne
authors.initials: J
authors.lastname: Lee
authors.forename: Serigne
authors.initials: S
authors.lastname: Lo
authors.forename: Colin
authors.initials: C
authors.lastname: McArthur
authors.forename: Shay
authors.initials: S
authors.lastname: McGuinness
authors.forename: Robyn
authors.initials: R
authors.lastname: Norton
authors.forename: John
authors.initials: J
authors.lastname: Myburgh
authors.forename: Carlos
authors.initials: C
authors.lastname: Sheinkestel
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D004032:Diet; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011506:Proteins / Q000008:administration & dosage*; D017582:Renal Replacement Therapy / Q000379:methods; D012720:Severity of Illness Index
chemical_list: D011506:Proteins