The study retrieved, assessed and synthesized the best evidence on nutritional management in adult patients undergoing continuous renal replacement therapy (CRRT) using the 5S pyramid of evidence model. Databases of systematic reviews, guidelines and protocols were searched from 1 January 2006 to 31 December 2025. Two experts in evidence-based nursing independently assessed quality and extracted data. Twelve documents were included: one clinical guideline, one evidence summary, eight guidelines and two consensus statements. Sixteen points of evidence were synthesized in three areas: nutritional assessment and route selection, energy and protein provision, electrolyte and micronutrient monitoring and supplementation. The best evidence is comprehensive and scientifically based, serving as a reference base for clinical practice. To improve results, it is recommended to develop personalized nutritional plans according to the patient's condition.