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Resting energy expenditure and its determinants in hemodialysis patients.

Abstract

OBJECTIVE

Chronic kidney disease is associated with several metabolic disturbances that can affect energy metabolism. As resting energy expenditure (REE) is scarcely investigated in patients on hemodialysis (HD) therapy, we aimed to evaluate the REE and its determinants in HD patients.

DESIGN

Cross-sectional study.

SETTING

Dialysis Unit of the Nephrology Division, Federal University of São Paulo, Brazil.

SUBJECTS

The study included 55 patients (28 male, 41.4+/-12.6 years old) undergoing HD therapy thrice weekly for at least 2 months, and 55 healthy individuals pair matched for age and gender. Subjects underwent fasting blood tests, as well as nutritional assessment, and the REE was assessed by indirect calorimetry.

RESULTS

REE of HD patients was similar to that of pair-matched controls (1379+/-272 and 1440+/-259 kcal/day, respectively), even when adjusted for fat-free mass (P=0.24). REE of HD patients correlated positively with fat-free mass (r=0.74; P<0.001) and body mass index (r=0.37; P<0.01), and negatively with dialysis adequacy (r=-0.46; P<0.001). No significant univariate correlation was found between REE and age, dialysis vintage, serum creatinine, urea, albumin, bicarbonate, parathyroid hormone (PTH) or high-sensitivity C-reactive protein (CRP). In the multiple linear regression analysis, using REE as dependent variable, the final model showed that besides the well-recognized determinants of REE such as fat-free mass and age, PTH and CRP were the independent determinants of REE in HD patients (R (2)=0.64).

CONCLUSIONS

In this study, the REE of HD patients was similar to that of healthy individuals, even with the positive effect of secondary hyperparathyroidism and inflammation on REE of these patients.

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  • Authors+Show Affiliations

    ,

    Nutrition Program, Federal University of São Paulo, São Paulo, Brazil.

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    MeSH

    Adult
    Age Factors
    Aged
    Basal Metabolism
    Body Composition
    Brazil
    C-Reactive Protein
    Calorimetry, Indirect
    Case-Control Studies
    Cross-Sectional Studies
    Energy Metabolism
    Female
    Humans
    Hyperparathyroidism, Secondary
    Kidney Failure, Chronic
    Male
    Middle Aged
    Muscle, Skeletal
    Nutrition Assessment
    Parathyroid Hormone
    Renal Dialysis

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    16943847

    Citation

    Kamimura, M A., et al. "Resting Energy Expenditure and Its Determinants in Hemodialysis Patients." European Journal of Clinical Nutrition, vol. 61, no. 3, 2007, pp. 362-7.
    Kamimura MA, Draibe SA, Avesani CM, et al. Resting energy expenditure and its determinants in hemodialysis patients. Eur J Clin Nutr. 2007;61(3):362-7.
    Kamimura, M. A., Draibe, S. A., Avesani, C. M., Canziani, M. E., Colugnati, F. A., & Cuppari, L. (2007). Resting energy expenditure and its determinants in hemodialysis patients. European Journal of Clinical Nutrition, 61(3), pp. 362-7.
    Kamimura MA, et al. Resting Energy Expenditure and Its Determinants in Hemodialysis Patients. Eur J Clin Nutr. 2007;61(3):362-7. PubMed PMID: 16943847.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Resting energy expenditure and its determinants in hemodialysis patients. AU - Kamimura,M A, AU - Draibe,S A, AU - Avesani,C M, AU - Canziani,M E F, AU - Colugnati,F A B, AU - Cuppari,L, Y1 - 2006/08/30/ PY - 2006/9/1/pubmed PY - 2007/4/24/medline PY - 2006/9/1/entrez SP - 362 EP - 7 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 61 IS - 3 N2 - OBJECTIVE: Chronic kidney disease is associated with several metabolic disturbances that can affect energy metabolism. As resting energy expenditure (REE) is scarcely investigated in patients on hemodialysis (HD) therapy, we aimed to evaluate the REE and its determinants in HD patients. DESIGN: Cross-sectional study. SETTING: Dialysis Unit of the Nephrology Division, Federal University of São Paulo, Brazil. SUBJECTS: The study included 55 patients (28 male, 41.4+/-12.6 years old) undergoing HD therapy thrice weekly for at least 2 months, and 55 healthy individuals pair matched for age and gender. Subjects underwent fasting blood tests, as well as nutritional assessment, and the REE was assessed by indirect calorimetry. RESULTS: REE of HD patients was similar to that of pair-matched controls (1379+/-272 and 1440+/-259 kcal/day, respectively), even when adjusted for fat-free mass (P=0.24). REE of HD patients correlated positively with fat-free mass (r=0.74; P<0.001) and body mass index (r=0.37; P<0.01), and negatively with dialysis adequacy (r=-0.46; P<0.001). No significant univariate correlation was found between REE and age, dialysis vintage, serum creatinine, urea, albumin, bicarbonate, parathyroid hormone (PTH) or high-sensitivity C-reactive protein (CRP). In the multiple linear regression analysis, using REE as dependent variable, the final model showed that besides the well-recognized determinants of REE such as fat-free mass and age, PTH and CRP were the independent determinants of REE in HD patients (R (2)=0.64). CONCLUSIONS: In this study, the REE of HD patients was similar to that of healthy individuals, even with the positive effect of secondary hyperparathyroidism and inflammation on REE of these patients. SN - 0954-3007 UR - https://www.unboundmedicine.com/medline/citation/16943847/Resting_energy_expenditure_and_its_determinants_in_hemodialysis_patients_ L2 - http://dx.doi.org/10.1038/sj.ejcn.1602516 DB - PRIME DP - Unbound Medicine ER -