Comparing High-protein Vs. Standard Protein Nutritional Support in Critically Ill Patients At Risk for Refeeding Syndrome

Inclusion Criteria: * Willingness to cooperate and complete the informed consent form by the patient or legal guardian; * age ≤ 18 years and \< 65 years; * Non-pregnant and non-lactating; * Serum creatinine ≥ 1.1 mg/dl for women and ≥ 1.2 mg/dl for men; * No organ failure at the time of study enrollment; * Intervention initiation within 48 hours of ICU admission; * No history of metastatic cancer or end-stage disease; * No absolute contraindications to enteral nutrition (e.g., persistent ileus, gastrointestinal ischemia, persistent or biliary vomiting, mechanical obstruction); * No active infections, sepsis, severe sepsis, or septic shock; * No intolerance to the whey protein supplement used in the current study; * Not participating in other clinical trials concurrently with this study; * No clinical conditions with higher or lower protein needs, such as burns, sepsis, cirrhosis, or chronic kidney disease; * No diabetes with severe complications such as ketoacidosis, hyperosmolar coma, or acidosis. Exclusion Criteria: * Unwillingness to continue cooperation during study; * Discharge or death of the patient earlier than 5 days from the start of the intervention; * Occurrence of side effects during the study