title: Energy expenditure in chronic kidney disease patients.
abstract: OBJECTIVE
  The assessment of energy expenditure in patients with chronic kidney disease (CKD) is a subject that has started to be investigated in the past 3 decades. This review will focus on studies that have assessed the energy expenditure of CKD predialysis and dialysis patients. Till date, most studies on this subject have focused on the assessment of resting energy expenditure (REE). In this regard, the current published data have demonstrated that clinically stable nondialysed CKD patients have REE similar or slightly lower than that of age- and gender-matched healthy individuals. For dialyzed patients, in both hemodialysis and peritoneal dialysis, the results are indicative that the REE of these patients is similar to that of age- and gender-matched healthy controls. The investigation of REE in specific catabolic conditions, such as poorly controlled diabetes, hyperparathyroidism, and inflammation, has shown that the REE in these catabolic conditions is increased. Additionally, it has also been reported that the hemodialysis procedure per se is also capable of enhancing the energy expenditure. The energy expenditure for physical activity is also an important component of energy expenditure and has been scarcely investigated in patients with CKD. The few studies that have investigated energy expenditure for physical activity have shown values lower than that of healthy sedentary individuals.
  
  
  CONCLUSIONS
  These results are highly suggestive that patients with CKD have a sedentary lifestyle. The effect of the present knowledge of energy expenditure on the energy requirements of the patients with CKD remains to be investigated in studies using gold standard methods for this purpose.
authors.affiliation: Department of Applied Nutrition, Nutrition Institute, Rio de Janeiro State University, Rua Francisco Xavier 524, Rio de Janeiro, RJ, Brazil. carla.avesani@carrenho.com.br
authors.forename: Carla Maria
authors.initials: CM
authors.lastname: Avesani
authors.forename: Maria Ayako
authors.initials: MA
authors.lastname: Kamimura
authors.forename: Lilian
authors.initials: L
authors.lastname: Cuppari
mesh_terms: D001481:Basal Metabolism; D004734:Energy Metabolism; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism*; D009043:Motor Activity; D006435:Renal Dialysis