The impact of higher protein dosing on outcomes in critically ill patients with acute kidney injury: a post hoc analysis of the EFFORT protein trial
Authors' conclusion
In critically ill patients with AKI, high protein may be associated with worse outcomes in all AKI stages.
Study context
- Population
- Critically ill patients with acute kidney injury (AKI) (Kidney Disease Improving Global Outcomes (KDIGO) criteria) within 7 days of ICU admissionof 1329 randomized
- Participants
- 312 patients
- Comparison
- High vs usual protein dose
- Highn = 163
- Usualn = 149reference
- Primary endpoint
- Time-to-discharge alive from the hospital (TTDA) and 60-day mortality
Primary result
As reported in the abstract
TTDA and 60-day mortality
High vs UsualEstimate (95% CI)
Slower TTDA
HR (TTDA) 0.5(0.4–0.8)
Higher mortality
RR (60-day mortality) 1.4(1.1–1.8)
Further findings
Subgroups (subgroup)
- Effect modification not statistically significant for any subgroup; no subgroup suggested benefit; harmful effect appeared to disappear in patients receiving kidney replacement therapy (KRT)
Incidence of AKI and KRT, duration of KRT
- Protein dose not significantly associated
Original publication
The impact of higher protein dosing on outcomes in critically ill patients with acute kidney injury: a post hoc analysis of the EFFORT protein trial. Crit Care. Published 18 October 2023. doi:10.
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