The Effect of IV Amino Acid Supplementation on Mortality in ICU Patients May Be Dependent on Kidney Function: Post Hoc Subgroup Analyses of a Multicenter Randomized Trial

Critical Care Medicine
Ran ZhuNephro-Protective Trial Investigators Group

Abstract

We investigated whether preexisting kidney function determines if ICU patients may benefit from increased (2.0 g/kg/d) protein intake. Post hoc, hypothesis-generating, subgroup analysis of a multicenter, phase 2, randomized clinical trial. All analyses were conducted by intention to treat and maintained group allocation. Ninety-day mortality was the primary outcome. ICUs of 16 hospitals throughout Australia and New Zealand. Adult critically ill patients expected to remain in the study ICU for longer than 2 days. Random allocation to receive a daily supplement of up to 100 g of IV amino acids to achieve a total protein intake of 2.0 g/kg/d or standard nutrition care. A total of 474 patients were randomized: 235 to standard care and 239 to IV amino acid supplementation. There was a statistically significant interaction between baseline kidney function and supplementation with study amino acids (p value for interaction = 0.026). Within the subgroup of patients with normal kidney function at randomization, patients who were allocated to receive the study amino acid supplement were less likely to die before study day 90 (covariate-adjusted risk difference, -7.9%; 95% CI, -15.1 to -0.7; p = 0.034). Furthermore, amino acid supplementa...Continue Reading

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Citations

Jun 16, 2019·Critical Care : the Official Journal of the Critical Care Forum·Pierre Singer
Jun 9, 2019·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Jayshil J PatelDaren K Heyland
Oct 27, 2018·Critical Care : the Official Journal of the Critical Care Forum·Jean-Charles Preiser
Nov 2, 2019·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Wilhelmus G P M LooijaardPeter J M Weijs
Aug 18, 2020·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Kensuke NakamuraNaoto Morimura

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