Summary of best evidence for nutritional management in adult patients undergoing continuous renal replacement therapy

Objective: To retrieve, screen, appraise, and synthesize the best evidence on nutritional management for adult patients undergoing continuous renal replacement therapy (CRRT) to inform the development of standardized clinical nutrition management protocols for CRRT. Methods: Using the 5S evidence pyramid model, we conducted a top-down search of domestic and international sources, including databases of systematic reviews, guideline portals, professional association websites, and comprehensive databases, to identify clinical decision aids, evidence summaries, guidelines, standards, protocols, systematic reviews, and expert consensus statements. The search period was from January 1, 2006, to December 31, 2025. Two evidence-based nursing experts independently performed quality appraisal, evidence extraction, and grading for the included literature. Results: A total of 12 documents were included: one clinical decision aid, one evidence summary, eight guidelines, and two expert consensus statements. After systematic extraction and integration of the relevant evidence, 16 evidence points were summarized across three domains: nutritional assessment and selection of nutritional pathways, energy and protein provision, and monitoring and supplementation of electrolytes and micronutrients. Conclusion: The best available evidence on nutritional management for adults undergoing CRRT synthesized in this study is comprehensive and scientifically sound. It provides a reference for clinical practice. However, personalized nutritional plans should be developed based on patients' clinical conditions to improve outcomes.