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Poor Agreement between Predictive Equations of Energy Expenditure and Measured Energy Expenditure in Critically Ill Acute Kidney Injury Patients.
Ann Nutr Metab. 2016; 68(4):276-84.AN

Abstract

BACKGROUND

There are multiple equations for predicting resting energy expenditure (REE), but how accurate they are in severe acute kidney injury (AKI) patients is not clear. Our aim was to determine if predictive equations for estimated REE accurately reflect the requirements of AKI patients.

METHODS

We included in this prospective and observational study AKI patients AKIN-3 assessed by indirect calorimetry (IC). Bland-Altman, intraclass correlation coefficient and precision (percentagem of predicted values within 10% of measured values) were performed to compare REE by equations with REE measured by IC.

RESULTS

IC was applied in 125 AKI patients. The mean age was 62.5 ± 16.6 and 65.6% were male. Mean REE measured was 2,029.11 ± 760.4 kcal/day. There were low precision, and poor agreement between measured and predicted REE by the Harris-Benedict (HB), Mifflin, Ireton-Jones, Penn state, American College of Chest Physicians, and Faisy equations. HB without using injury factor was the least precise (18% of precision). Modified Penn state equation had the best precision, although the precision rate was only 41%. For all equations, the limits of agreement range were large leading to the potential under or overfeeding of individual patients.

CONCLUSION

None of these equations accurately estimated measured REE in severe AKI patients and most of them underestimated energy needs.

Authors+Show Affiliations

Internal Medicine Department, Acute Kidney Injury Group, UNESP - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu, Brazil.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

27288392

Citation

de Góes, Cassiana R., et al. "Poor Agreement Between Predictive Equations of Energy Expenditure and Measured Energy Expenditure in Critically Ill Acute Kidney Injury Patients." Annals of Nutrition & Metabolism, vol. 68, no. 4, 2016, pp. 276-84.
de Góes CR, Berbel-Bufarah MN, Sanches AC, et al. Poor Agreement between Predictive Equations of Energy Expenditure and Measured Energy Expenditure in Critically Ill Acute Kidney Injury Patients. Ann Nutr Metab. 2016;68(4):276-84.
de Góes, C. R., Berbel-Bufarah, M. N., Sanches, A. C., Xavier, P. S., Balbi, A. L., & Ponce, D. (2016). Poor Agreement between Predictive Equations of Energy Expenditure and Measured Energy Expenditure in Critically Ill Acute Kidney Injury Patients. Annals of Nutrition & Metabolism, 68(4), 276-84. https://doi.org/10.1159/000446708
de Góes CR, et al. Poor Agreement Between Predictive Equations of Energy Expenditure and Measured Energy Expenditure in Critically Ill Acute Kidney Injury Patients. Ann Nutr Metab. 2016;68(4):276-84. PubMed PMID: 27288392.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Poor Agreement between Predictive Equations of Energy Expenditure and Measured Energy Expenditure in Critically Ill Acute Kidney Injury Patients. AU - de Góes,Cassiana R, AU - Berbel-Bufarah,Marina N, AU - Sanches,Ana Claudia S, AU - Xavier,Patrícia S, AU - Balbi,André L, AU - Ponce,Daniela, Y1 - 2016/06/10/ PY - 2015/09/07/received PY - 2016/05/09/accepted PY - 2016/6/12/entrez PY - 2016/6/12/pubmed PY - 2017/12/19/medline SP - 276 EP - 84 JF - Annals of nutrition & metabolism JO - Ann. Nutr. Metab. VL - 68 IS - 4 N2 - BACKGROUND: There are multiple equations for predicting resting energy expenditure (REE), but how accurate they are in severe acute kidney injury (AKI) patients is not clear. Our aim was to determine if predictive equations for estimated REE accurately reflect the requirements of AKI patients. METHODS: We included in this prospective and observational study AKI patients AKIN-3 assessed by indirect calorimetry (IC). Bland-Altman, intraclass correlation coefficient and precision (percentagem of predicted values within 10% of measured values) were performed to compare REE by equations with REE measured by IC. RESULTS: IC was applied in 125 AKI patients. The mean age was 62.5 ± 16.6 and 65.6% were male. Mean REE measured was 2,029.11 ± 760.4 kcal/day. There were low precision, and poor agreement between measured and predicted REE by the Harris-Benedict (HB), Mifflin, Ireton-Jones, Penn state, American College of Chest Physicians, and Faisy equations. HB without using injury factor was the least precise (18% of precision). Modified Penn state equation had the best precision, although the precision rate was only 41%. For all equations, the limits of agreement range were large leading to the potential under or overfeeding of individual patients. CONCLUSION: None of these equations accurately estimated measured REE in severe AKI patients and most of them underestimated energy needs. SN - 1421-9697 UR - https://www.unboundmedicine.com/medline/citation/27288392/Poor_Agreement_between_Predictive_Equations_of_Energy_Expenditure_and_Measured_Energy_Expenditure_in_Critically_Ill_Acute_Kidney_Injury_Patients_ L2 - https://www.karger.com?DOI=10.1159/000446708 DB - PRIME DP - Unbound Medicine ER -