ABSTRACT
In this chapter our goal is to outline the current knowledge and understanding of the literature as it pertains to the management of nutritional support for the critically ill patient. Following a discussion of the metabolic response to critical illness and acute renal failure (ARF), we review general principles applicable to patients in the intensive care unit (ICU) and identify the issues that are specific to the critically ill patient with renal dysfunction. Acute renal failure in the critical care setting usually occurs as part of multiple organ system dysfunction resulting from the underlying disease process. The general principles of nutritional management of critically ill patients with ARF are not significantly different from those of patients without ARF. There are, however, specific metabolic consequences of ARF and renal replacement therapy (RRT) that require special consideration.
