Figure 184

Estimation of energy requirements. Energy requirements of patients with acute renal failure (ARF) have been grossly overestimated in the past and energy intakes of more than 50 kcal/kg of body weight (BW) per day (ie, about 100% above resting energy expenditure (REE) haven been advocated [6]. Adverse effects of overfeeding have been extensively documented during the last decades, and it should be noted that energy intake must not exceed the actual energy consumption. Energy requirements can be calculated with sufficient accuracy by standard formulas such as the Harris Benedict equation. Calculated REE should be multiplied with a stress factor to correct for hypermetabolic disease; however, even in hypercatabolic conditions such as sepsis or multiple organ dysfunction syndrome, energy requirements rarely exceed 1.3 times calculated REE [1].

Protein metabolism

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