IMPACT OF CALORIC-PROTEIN SUPPLY ON RENAL FUNCTION OF SURGICAL ONCOLOGY PATIENTS ON ENTERAL NUTRITION

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https://storage.unitedwebnetwork.com/files/1099/38c7967abfe55a1673d0f9aaeea7bb82.pdf

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IMPACT OF CALORIC-PROTEIN SUPPLY ON RENAL FUNCTION OF SURGICAL ONCOLOGY PATIENTS ON ENTERAL NUTRITION

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Co-author 1

Moises Iasley Lima Vasconcelos moises.iasley@aluno.uece.br Instituto do Cancer do Ceara Multidisciplinary residency Fortaleza Brazil -

Co-author 2

Ruth Iallen Lima Vasconcelos ruthiallen@gmail.com Centro Universitario Estacio do Ceara Nutrition Fortaleza Brazil -

Co-author 3

Raquel Martins Uchôa raqueluchoa@yahoo.com.br Universidade Estadual do Ceara Nutrition and Public Health Fortaleza Brazil -

Co-author 4

Tatiana Uchôa Passos tatianapassos@gmail.com Universidade Estadual do Ceara Nutrition and Public Health Fortaleza Brazil -

Co-author 5

Semiramis Silva Santos semiramissantos@gmail.com Instituto do Cancer do Ceara Multidisciplinary residency Fortaleza Brazil -

Co-author 6

Paulo Goberlanio Barros Silva paulogoberlanio@gmail.com Instituto do Cancer do Ceara Multidisciplinary residency Fortaleza Brazil -

Co-author 7

Sara Maria Moreira Lima Verde saralimaverde@gmail.com Universidade Estadual do Ceara Nutrition and Public Health Fortaleza Brazil -

Co-author 8

Adila da Silva Castro adilacastro@yahoo.com.br Universidade de Fortaleza Nutrition Fortaleza Brazil -

Co-author 9

Geraldo Bezerra da Silva Junior geraldobsilvajr@yahoo.com Universidade de Fortaleza Fellow of the International Society of Nephrology Fortaleza Brazil *

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Acute Kidney Injury (AKI) is a common complication in hospitalized patients with cancer undergoing major surgery. Nutritional therapy, especially protein and caloric intake, may influence renal recovery in this population. The aim of this study is to evaluate the association between caloric and protein intake from enteral nutritional therapy (ENT) and serum creatinine reduction in surgical oncology patients with AKI.

Methods

A retrospective cohort study was conducted with 22 adult cancer patients hospitalized in a reference oncology center in Fortaleza, northeast of Brazil, between September 2024 and January 2025. All patients underwent major surgery, developed AKI (KDIGO 1–3), and received exclusive ENT. Nutritional intake data, renal function markers, and clinical variables were analyzed using REDCap and SPSS 20.0, with statistical significance set at p<0.05.

Results

The cohort, n=22, was predominantly male (68.2%) and Black (45.5%), with 40.9% presenting malnutrition at admission. Most patients failed to meet caloric (77.3%) and protein (95.5%) targets within the first 3 days. However, protein intake between days 5–7 was significantly associated with creatinine reduction (p=0.011). Patients reaching >89% of the protein prescription showed improved renal function. Notably, Black patients and those undergoing gastrointestinal surgeries had higher rates of creatinine reduction (70%, p=0.037). High gastric residuals were more frequent in patients without renal improvement (p=0.019), suggesting a link between enteral tolerance and renal outcomes.

Conclusion

Adequate protein intake after the 5th day of hospitalization appears to play a crucial role in renal recovery among cancer patients with AKI. Early hypocaloric nutrition followed by progressive protein optimization may be beneficial. Further prospective studies are needed to refine nutritional strategies in this vulnerable population.

Kewords