Agreements between Indirect Calorimetry and Prediction Equations of Resting Energy Expenditure in End-Stage Renal Disease Patients on Continuous Ambulatory Peritoneal Dialysis

Abstract

PurposeEquations are frequently used to estimate resting energy expenditure (REE) in a clinical setting. However, few studies have examined their accuracy in end-stage renal disease (ESRD) patients.Materials and MethodsTo investigate agreement between indirect calorimetry and several REE estimating equations in 38 ESRD patients on peritoneal dialysis, we performed indirect calorimetry and compared the results with REEs estimated using 5 equations [Harris-Benedict (HBE), Mifflin, WHO, Schofield, and Cunningham].ResultsMeasured REE was 1393.2 ± 238.7 kcal/day. There were no significant differences between measured and estimated REEs except Mifflin (1264.9 ± 224.8 kcal/day). Root mean square errors were smallest for HBE, followed by Schofield, Cunningham, and WHO, and largest for Mifflin (171.3, 171.9, 174.6, 175.3, and 224.6, respectively). In Bland-Altman plot, correlation coefficients between mean values and differences were significant for HBE (r = 0.412, p = 0.012) and tended to be significant for Cunningham (r = 0.283, p = 0.086). In DM patients and patients with overhydration, HBE showed significant underestimation when REE increased.ConclusionIn ESRD patients on continuous ambulatory peritoneal dialysis (CAPD), REE-estimating equations have no significant differences from indirect calorimetry, except Mifflin. However, HBE showed greater bias than others when REE was high.

Development of a Predictive Energy Equation for Maintenance Hemodialysis Patients: A Pilot Study

“…Application of commonly used predictive equations in clinical practice (i.e., Harris-Benedict Equation (HBE), Schoenfeld, Mifflin-St Jeor (MJSE), etc.) have been studied on a limited basis in CKD, and have produced conflicting results, e.g., under- or over-estimation of energy requirements when compared to the mREE obtained by IC (8, 11, 20). Consequently, existing predictive energy equations are not reliable for use in CKD, and especially among those patients on MHD (11).…”

Patients receiving dialysis do not have increased energy needs compared with healthy adults

“…However, Lee et al . () found a significant overestimation only with Mifflin St Joer. Based on the research of Shah et al .…”

“…Interestingly, one study found all predictive energy equations, Schofield, WHO and Harris Benedict, to significantly overestimate energy needs while the other study found only Mifflin St Joer to exceed energy needs (p < 0.05) (Lee et al . ; Dias Rodrigues et al . ).…”

“…Two studies in Table also compared predictive energy equations to indirect calorimetry and found differing results (Lee et al . ; Dias Rodrigues et al . ).…”

Estimativa das necessidades energéticas em pacientes com doença renal crônica

“…Há ainda outras equações também referenciadas em artigos científicos 33,34 , mas menos empregadas 35,36 . 31 , FAO-1985 32 e FAO-2001 (ou de Schofield) 11 foram desenvolvidas a partir de análise de regressões de estudos que avaliaram a TMB de diferentes populações.…”