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Background and Importance Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterised by multisystem involvement, inflammation, and tissue damage. Patients with renal and metabolic complications require complex therapeutic management. Severe hypertriglyceridemia and renal dysfunction can complicate parenteral nutrition, making individualised pharmaceutical intervention essential to ensure metabolic safety and adequate nutritional support.Aim and Objectives To describe the clinical management and pharmaceutical intervention in a patient with newly diagnosed SLE, acute renal failure, and severe hypertriglyceridemia requiring total parenteral nutrition (TPN).Material and Methods A 32-year-old female patient was admitted to the intensive care unit (ICU) in March 2025 with mixed shock and acute renal failure (glomerular filtration rate 17 mL/min). Immunological testing confirmed SLE (anti-dsDNA, anti-Sm, anti-histone, and low complement levels). The patient presented severe hypertriglyceridemia (617 mg/dL) and mucositis with poor oral tolerance, requiring TPN initiation. The pharmacy service collaborated with the endocrinology and nutrition teams to calculate energy requirements (1980 kcal/day, stress factor 1.5). A customised TPN was designed to cover 75% of caloric needs to prevent refeeding syndrome, with restricted protein (0.8 g/kg) and no lipids due to renal impairment and elevated triglycerides respectively. After clinical improvement and normalisation of renal function, TPN was reformulated to provide 1.5 g/kg protein and full caloric requirements.Results After 7 days of TPN, the patient showed progressive improvement in renal function and inflammatory parameters. Triglyceride levels decreased, and oral tolerance improved. TPN was discontinued, and oral lipid-free nutritional supplements were initiated. The multidisciplinary approach allowed for close metabolic monitoring and individualised adjustment of macronutrients, ensuring nutritional adequacy and treatment safety.Conclusion and Relevance This case illustrates the crucial role of hospital pharmacists in optimising parenteral nutrition for complex autoimmune patients with renal and metabolic complications. The pharmaceutical intervention ensured safe TPN formulation, minimised metabolic risks, and supported clinical recovery. Multidisciplinary collaboration between pharmacy, nutrition, and medical teams is essential for improving outcomes in critically ill patients with SLE and severe dyslipidaemia.Conflict of Interest No conflict of interest