Bengoa J M
Schweiz Med Wochenschr. 1986 Apr 26;116(17):535-8.
The catabolic stress induced by acute renal failure is multifactorial in origin. Uremia is associated with increased protein degradation presumably due to toxic effects of increased metabolic products and to hormonal alterations. Moreover, anorexia and loss of nutrients during dialysis further contribute to protein-energy malnutrition. The goals of nutritional support are to reduce uremia, preserve nutritional status and accelerate renal function recovery. In fact, the indications for enteral or parenteral nutritional support in acute renal failure are primarily founded on clinical criteria rather than on a controlled demonstration of efficacy. The specific metabolic conditions imposed by renal failure on protein, carbohydrate, lipid and micronutrient homeostasis must be addressed. Total parenteral nutrition can be administered safely in acute renal failure, provided strict control of prescription and follow-up is achieved in order to avoid potentially serious complications.
急性肾衰竭所致的分解代谢应激源于多方面因素。尿毒症与蛋白质降解增加有关，这可能是由于代谢产物增加的毒性作用以及激素改变所致。此外，透析期间的厌食和营养流失进一步导致蛋白质 - 能量营养不良。营养支持的目标是减轻尿毒症、维持营养状况并加速肾功能恢复。事实上，急性肾衰竭患者肠内或肠外营养支持的指征主要基于临床标准，而非疗效的对照性证明。必须解决肾衰竭对蛋白质、碳水化合物、脂质和微量营养素稳态所施加的特定代谢状况。只要严格控制处方和随访以避免潜在的严重并发症，全胃肠外营养在急性肾衰竭患者中可以安全实施。
