The ROBINS-I assessment showed moderate-to-severe bias (10 severe, 8 moderate).<h4>Conclusion</h4>The meta-analysis identified serum levels of phosphorus and albumin; daily protein and calorie intake; APACHE II score; SOFA score; age; initiation of feeding within 48 h of ICU admission; and a history of diabetes as significant predictors of RFS development in critically ill patients. Here, ALB is linked to diabetes mellitus.