Agreements between indirect calorimetry and prediction equations of resting energy expenditure in end-stage renal disease patients on continuous ambulatory peritoneal dialysis.
OBJECTIVE
Equations 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.


METHODS
To 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].


RESULTS
Measured 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.


CONCLUSIONS
In 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.
Lee
Seoung Woo
SW
Division of Nephrology and Hyperfension, Department of Internal Medicine, Kidney Desease Research Group, Inha University College of Medicine, 7-206 3-ga, Sinhung-dong, Jung-gu, Incheon 400-711, Korea.
Kim
Hyo Jung
HJ
Kwon
Hei Kyung
HK
Son
Sook Mee
SM
Song
Joon Ho
JH
Kim
Moon-Jae
MJ
D000293:Adolescent; D000328:Adult; D002153:Calorimetry, Indirect / Q000379:methods*; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000379:methods*