Are branched-chain amino acids (BCAAs) recommended in AKI PN?

• A. Yes
• B. No
• C. Only when dialysis is used
• D. In all AKI PN regimens

Answer: (B)

Branched-chain amino acids are not routinely recommended in PN for acute kidney injury because there’s no demonstrated benefit in this setting, and adding BCAAs can increase the nitrogen load the damaged kidneys must handle. In AKI, the goal is to provide a balanced amino acid profile that meets protein needs without unnecessarily elevating nitrogenous waste. BCAA-enriched formulas are primarily used for hepatic encephalopathy in liver disease, not AKI, so they don’t align with AKI PN goals. Therefore, the best approach is not to use BCAA-enriched PN in AKI. The other options imply selective or universal use, which isn’t supported by current practice in AKI PN.