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Determinants of resting energy expenditure in hemodialysis patients, and comparison with healthy subjects.

Abstract

OBJECTIVE

This study evaluated the factors that affect the resting energy expenditure (REE) and nutritional status of hemodialysis patients, and to assess any differences with healthy subjects.

DESIGN

This was an observational case-control study.

SETTING

This study took place at the Hemodialysis Units of the Laikon General Hospital and 401 General Military Hospital (Athens, Greece).

PATIENTS

Twenty-five patients undergoing hemodialysis and 23 controls were recruited. Controls were healthy volunteers with no history of diseases or medication use. Patients with active infectious or inflammatory disease were excluded.

INTERVENTION

We measured REE using indirect calorimetry. Body composition as measured by Bioelectrical Impedance Analysis (BIA), anthropometry, and biochemical parameters were assessed in both groups.

MAIN OUTCOME MEASURE

Adjusted or unadjusted for muscle mass, REE was compared between the two groups. Multiple linear regression analysis was used to study independent determinants of REE.

RESULTS

Patients had no clinical signs of malnutrition. Resting energy expenditure was not different between the two groups, but REE adjusted for muscle mass was significanlty higher in hemodialysis patients. There were no differences in body composition, with the exception of muscle mass. Patients had lower muscle mass than controls, as determined by duration of disease. The only significant determinant of REE was muscle mass.

CONCLUSION

Patients had a higher REE adjusted for muscle mass than did controls, implying that they might be at a catabolic stage, and at risk of malnutrition. These findings indicate the need for determining body composition and for nutritional assessment and support in hemodialysis patients, even without indications of malnutrition.

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  • Authors+Show Affiliations

    ,

    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece. diatrofi@hygeia.gr

    , , , ,

    Source

    MeSH

    Adult
    Anthropometry
    Body Composition
    Calorimetry, Indirect
    Diabetes Mellitus, Type 2
    Diabetic Nephropathies
    Electric Impedance
    Energy Metabolism
    Female
    Humans
    Kidney Failure, Chronic
    Linear Models
    Male
    Muscle, Skeletal
    Nutritional Status
    Renal Dialysis
    Rest

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    19539183

    Citation

    Skouroliakou, Maria, et al. "Determinants of Resting Energy Expenditure in Hemodialysis Patients, and Comparison With Healthy Subjects." Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, vol. 19, no. 4, 2009, pp. 283-90.
    Skouroliakou M, Stathopoulou M, Koulouri A, et al. Determinants of resting energy expenditure in hemodialysis patients, and comparison with healthy subjects. J Ren Nutr. 2009;19(4):283-90.
    Skouroliakou, M., Stathopoulou, M., Koulouri, A., Giannopoulou, I., Stamatiades, D., & Stathakis, C. (2009). Determinants of resting energy expenditure in hemodialysis patients, and comparison with healthy subjects. Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, 19(4), pp. 283-90. doi:10.1053/j.jrn.2009.01.025.
    Skouroliakou M, et al. Determinants of Resting Energy Expenditure in Hemodialysis Patients, and Comparison With Healthy Subjects. J Ren Nutr. 2009;19(4):283-90. PubMed PMID: 19539183.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Determinants of resting energy expenditure in hemodialysis patients, and comparison with healthy subjects. AU - Skouroliakou,Maria, AU - Stathopoulou,Maria, AU - Koulouri,Aikaterini, AU - Giannopoulou,Ifigenia, AU - Stamatiades,Dimitrios, AU - Stathakis,Charalampos, PY - 2008/03/27/received PY - 2009/6/23/entrez PY - 2009/6/23/pubmed PY - 2009/8/28/medline SP - 283 EP - 90 JF - Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation JO - J Ren Nutr VL - 19 IS - 4 N2 - OBJECTIVE: This study evaluated the factors that affect the resting energy expenditure (REE) and nutritional status of hemodialysis patients, and to assess any differences with healthy subjects. DESIGN: This was an observational case-control study. SETTING: This study took place at the Hemodialysis Units of the Laikon General Hospital and 401 General Military Hospital (Athens, Greece). PATIENTS: Twenty-five patients undergoing hemodialysis and 23 controls were recruited. Controls were healthy volunteers with no history of diseases or medication use. Patients with active infectious or inflammatory disease were excluded. INTERVENTION: We measured REE using indirect calorimetry. Body composition as measured by Bioelectrical Impedance Analysis (BIA), anthropometry, and biochemical parameters were assessed in both groups. MAIN OUTCOME MEASURE: Adjusted or unadjusted for muscle mass, REE was compared between the two groups. Multiple linear regression analysis was used to study independent determinants of REE. RESULTS: Patients had no clinical signs of malnutrition. Resting energy expenditure was not different between the two groups, but REE adjusted for muscle mass was significanlty higher in hemodialysis patients. There were no differences in body composition, with the exception of muscle mass. Patients had lower muscle mass than controls, as determined by duration of disease. The only significant determinant of REE was muscle mass. CONCLUSION: Patients had a higher REE adjusted for muscle mass than did controls, implying that they might be at a catabolic stage, and at risk of malnutrition. These findings indicate the need for determining body composition and for nutritional assessment and support in hemodialysis patients, even without indications of malnutrition. SN - 1532-8503 UR - https://www.unboundmedicine.com/medline/citation/19539183/Determinants_of_resting_energy_expenditure_in_hemodialysis_patients_and_comparison_with_healthy_subjects_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1051-2276(09)00047-8 DB - PRIME DP - Unbound Medicine ER -