title: Increased resting energy expenditure in patients with end-stage renal disease.
abstract: BACKGROUND
  Protein-calorie malnutrition is a significant problem for patients with end-stage renal disease. Increased resting energy expenditure may be an important contributing factor. We postulate that resting energy expen diture in the different stages of renal disease and treatments may be different.
  
  
  METHODS
  Resting energy expenditure was measured using a whole-room indirect calorimeter (metabolic chamber) along with nutritional parameters and body composition after 12-hour fasting in 15 patients with advanced chronic renal failure patients, 15 patients on chronic hemodialysis, and 10 patients on peritoneal dialysis. Patients on hemodialysis were assessed on a non-dialysis day. A 2-day dietary recall was used to assess energy intake.
  
  
  RESULTS
  Resting energy expenditure, adjusted for fat-free mass, was similar in patients on hemodialysis and peritoneal dialysis but significantly higher than in patients with chronic renal failure (p < .05). Resting energy expenditure in all patients were generally higher (10% to 20%) than predicted values using standard equations derived in normal and obese populations, whereas daily energy intake was less (26% to 34%) than energy expenditure for all groups, adjusted for light daily activity.
  
  
  CONCLUSIONS
  End-stage renal disease patients displayed increases in resting energy expenditure over the predicted values derived using normal populations. Resting energy expenditure was significantly higher in patients receiving dialysis, regardless of the modality, than patients with chronic renal failure. Daily energy intake was substantially less than required in all patient groups studied, suggesting that patients with renal failure could develop protein-calorie malnutrition because of increased resting energy expenditure, which is exacerbated by dialysis.
authors.affiliation: Arizona Kidney Disease Center, Phoenix, USA.
authors.forename: Roxanna
authors.initials: R
authors.lastname: Neyra
authors.forename: Kong Y
authors.initials: KY
authors.lastname: Chen
authors.forename: Ming
authors.initials: M
authors.lastname: Sun
authors.forename: Yu
authors.initials: Y
authors.lastname: Shyr
authors.forename: Raymond M
authors.initials: RM
authors.lastname: Hakim
authors.forename: T Alp
authors.initials: TA
authors.lastname: Ikizler
mesh_terms: D001798:Blood Proteins / Q000032:analysis; D001823:Body Composition / Q000502:physiology; D002395:Catecholamines / Q000097:blood; D003430:Cross-Sectional Studies; D015930:Diet Records; D018450:Disease Progression; D017097:Electric Impedance; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012146:Rest / Q000502:physiology
chemical_list: D001798:Blood Proteins; D002395:Catecholamines