Increased resting energy expenditure in patients with end‐stage renal disease

Neyra, R; Chen, Kong Y.; Sun, Mei; Shyr, Yu; Hakim, R. M.; İkizler, T. Alp

doi:10.1177/014860710302700136

Cited by 74 publications

(53 citation statements)

References 17 publications

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“…Increased REE, if unmatched by increased energy intake, may aggravate loss of both weight [1] and lean body mass, which are independent predictors of mortality in HIV-infected patients [2][3][4][5][6]. A similar phenomenon of increased REE has been observed in other chronic diseases, such as end-stage renal disease [7], rheumatoid arthritis [8], cancer [9], and chronic obstructive pulmonary disease [10]. Interventions, such as diet counseling [11,12], nutritional supplementation expenditure in other patient populations.…”

mentioning

confidence: 76%

Dysregulated Energy Expenditure in HIV-Infected Patients: A Mechanistic Review

Chang¹,

Sekhar²,

Patel³

et al. 2007

Clinical Infectious Diseases

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Metabolic abnormalities are common in patients with human immunodeficiency virus (HIV) infection and range from protein catabolism to lipodystrophy and dyslipidemia associated with the use of highly active antiretroviral therapy. One abnormality is increased resting energy expenditure, which even occurs in clinically stable HIV-infected patients. Increased resting energy expenditure may aggravate the tendency towards weight loss and wasting, which are independent predictors of mortality. Despite much investigation, the factors associated with altered resting energy expenditure remain unclear; viral load, CD4 cell count, use of antiretroviral drugs, body composition, hormones, and proinflammatory cytokines have been imputed. Mechanisms that could explain increased resting energy expenditure include the HIV accessory protein viral protein R, antiretroviral drugs that affect mitochondrial function, and futile cycling within adipocytes. Other components of energy expenditure are also important to overall energy balance and may also be affected. Identifying unifying mechanisms will be an important step to finding effective treatments for HIV-related alterations in energy expenditure and to reversing metabolic risks in patients with HIV infection.

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mentioning

confidence: 76%

Dysregulated Energy Expenditure in HIV-Infected Patients: A Mechanistic Review

Chang¹,

Sekhar²,

Patel³

et al. 2007

Clinical Infectious Diseases

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“…17, 25–27 Most studies indicate that the energy needs of MHD patients are similar to normal people of similar age, body weight and gender who are engaged in sedentary or light physical activity. 11, 28 A few studies suggest that their resting energy expenditure might be slightly increased in these patients, 29, 30 Thus, the combination of all of the foregoing evidence strongly indicates that the low reported energy intakes in clinically stable MHD patients who have stable body weights cannot be explained by lower energy needs for MHD patients.…”

Section: Discussionmentioning

confidence: 99%

Self-Reported Interview-Assisted Diet Records Underreport Energy Intake in Maintenance Hemodialysis Patients

Shapiro

Morrison

Kalantar-Zadeh

et al. 2015

Journal of Renal Nutrition

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Objective Studies suggest that maintenance hemodialysis (MHD) patients report dietary energy intakes (EI) that are lower than what is actually ingested. Data supporting this conclusion have several important limitations. The present study introduces a novel approach of assessing underreporting of EI in MHD patients. Design Comparisons of EI of free-living MHD patients determined from food records to their measured energy needs. Setting Metabolic research ward. Subjects 13 clinically stable MHD patients with unchanging weights whose EI was assessed by dietitian-interview-assisted 3-day food records. Intervention EI was compared to 1) patients’ resting energy expenditure (REE), measured by indirect calorimetry, and estimated total energy expenditure (TEE), and 2) patients’ dietary energy requirements (DER) measured while patients underwent nitrogen balance studies and consumed a constant energy diet in a research ward for a mean duration of 89.5 days. DER was calculated as the actual EI during the research study corrected for changes in body fat and lean body mass measured by Dual X-Ray Absorptiometry (DEXA). Main Outcome Measure Underreporting of energy intake was determined by an EI:REE ratio <1.27 and an EI:TEE ratio or EI:DEE ratio <1.0. Results Seven of the 13 MHD patients studied were male. Patient’s ages were 47.7±SD 9.7 years; BMI averaged 25.4±2.8 kg/m2, and dialysis vintage was 53.3±37.1 months. The EI:REE ratio (1.03±0.23) was significantly less than the cut-off value for under-reporting of 1.27 (p=0.001); 12 of 13 patients had EI:REE ratios <1.27. The mean EI:TEE ratio was significantly less than the cut-off value of 1.0 (0.73±0.17, p<0.0001), and 12 MHD patients had EI:TEE ratios <1.0. The EI:DER ratio was also less than 1.0 (0.83±0.25, p=0.012), and 10 MHD had EI:DER ratios <1.0. Conclusion Dietitian interview-assisted diet records by MHD patients substantially underestimate the patient’s dietary energy intake.

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“…Increased resting energy expenditure (REE), which is one of three major components of total daily energy expenditure (TEE), is observed in most chronic inflammatory conditions such as congestive heart failure, rheumatoid arthritis, and various cancers [34,35]. Although the exact mechanism of the increased REE in patients with chronic inflammatory disease is not clear, a high REE has been observed in association with increased concentrations of pro-inflammatory cytokines, and ESRD patients also have increased REE [36]. Other indirect effects of chronic inflammation predisposing CKD patients to hypercatabolism include a decrease in voluntary activity and the presence of an underlying disease requiring bed rest [37].…”

Section: Chronic Inflammationmentioning

confidence: 99%

Malnutrition in patients with chronic kidney disease

Chung¹,

Koh²,

Shin³

et al. 2012

OJIM

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Malnutrition is a major issue in patients with chronic kidney disease (CKD), adversely affecting morbidity, mortality, functional activity and patients’ quality of life. Our knowledge of the pathogenic mechanisms of malnutrition in patients with CKD, including endstage renal disease, has been improved. This has led to the development of clinical practice guidelines for nutritional care in CKD which provide a framework for the nutritional issues facing patients and physiccians. Extensive research in the field of nutrition in patients with CKD has resulted in the formation of general guidelines, although some uncertainties still exist on some of the best therapeutic or preventive options in uremic malnutrition. It is important to search actively for malnutrition since early diagnosis and treatment can improve the prognosis for CKD patients and reduce the monetary costs connected with treatment

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Increased resting energy expenditure in patients with end‐stage renal disease

Cited by 74 publications

References 17 publications

Dysregulated Energy Expenditure in HIV-Infected Patients: A Mechanistic Review

Dysregulated Energy Expenditure in HIV-Infected Patients: A Mechanistic Review

Self-Reported Interview-Assisted Diet Records Underreport Energy Intake in Maintenance Hemodialysis Patients

Malnutrition in patients with chronic kidney disease

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