Table 4.

Guidelines for nutritional requirements in acute kidney injury

Nutritional requirements	ESPEN 2006	ASPEN 2016	KDIGO 2012	Indian practice guidelines (2018)
Energy	20–30 kcal/kg body weight/day	25–30 kcal/kg/day	20-30 kcal/kg body weight/day
Carbohydrates	3–5 g (max 7)/kg body weight/day
Fat	0.8–1.2 (max 1.5) g/kg body weight/day		Noncatabolic state: 0.8—1 g/kg body weight/day	1.2–1.7 g/kg actual body weight/day
Protein (essential and nonessential amino acids)		1.2–2 g/kg/day	On RRT 1.0–1.5 g/kg body weight/day
Conservative therapy	0.6–0.8 (max. 1.0) g/kg body weight/day	Frequent hemodialysis or CRRT 2.5 g/kg/day	On CRRT 1.7 g/kg body weight/day
Extracorporeal therapy	1.0–1.5 g/kg body weight/day
Continuous renal replacement therapy (CRRT), in hypercatabolism	Up to maximum 1.7 g/kg body weight/day
Micronutrients	Extracorporeal treatment causes increased loss of micronutrients which should be supplemented. Excessive supplementation may result in toxicity. Micronutrient status should therefore be monitored
Preferred route of feeding	Nasogastric (NG) route is a standard method of access for EN administration		EN preferred	Standard EN formula
	Jejunal tube in the presence of severe impairment of GI motility			Low potassium and low phosphate levels can be implemented where the corresponding serum levels are high
	PN to be considered when requirements cannot be met via EN
	Oral nutrition supplements (ONS) may be beneficial to meet the requirements when spontaneous alimentation is insufficient