For the purposes of this guideline, acutely ill refers to an acute medical or surgical illness associated with a state of increased catabolism. Such events would be expected to increase the protein and energy requirements. Hospitalization is not a prerequisite for this definition.
Few data exist on the protein requirements of acutely ill MD patients.
There is no reason to assume that the protein requirements of the acutely ill MD patient is less than that needed by the clinically stable MD patient. It is proposed that these higher protein intakes may preserve or even replete body protein more effectively than lower protein intakes. However, there are no data as to whether these benefits will occur in acutely ill MD patients. Because acutely ill MD patients are generally very inactive physically, their energy needs will be diminished by the extent to which their physical activity has been decreased. In acutely ill nonrenal patients, REE may increase modestly, and daily energy requirements are not increased over normal.