Yonsei Med J.  2008 Apr;49(2):255-264. 10.3349/ymj.2008.49.2.255.

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

• Lee SW
• Kim HJ
• Kwon HK
• Son SM
• Song JH
• Kim MJ

• KMID: 1084499
• DOI: http://doi.org/10.3349/ymj.2008.49.2.255

Abstract

PURPOSE
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. PATIENTS AND 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 +/- 238.7kcal/day. There were no significant differences between measured and estimated REEs except Mifflin (1264.9 +/- 224.8kcal/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. CONCLUSION: 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.

Keyword

Energy metabolism; chronic kidney failure; continuous ambulatory peritoneal dialysis

MeSH Terms

Adolescent
Adult
Calorimetry, Indirect/*methods
*Energy Metabolism
Female
Humans
Kidney Failure, Chronic/metabolism/*therapy
Male
Middle Aged
Models, Biological
Peritoneal Dialysis, Continuous Ambulatory/*methods

Figure

• 

  Fig. 1 Bland-Altman plot between the mean values of measured and estimated REE and difference between measured and estimated REE using (A) HBE, (B) WHO, (C) Schofield, (D) Mifflin, and (E) Cunningham equations in all study subjects (n = 38). The 3 horizontal lines represent + 2SD, mean, and - 2SD of the differences between measured and estimated REE values. HBE, REE by Harris Benedict equation; Mifflin, REE by Mifflin equation; WHO, REE by WHO equation; Schofield, REE by Schofield equation; Cunningham, REE by Cunningham equation.

• 

  Fig. 2 Correlation between measured REE and HBE in total patients, normohydrated patients (open circle) and overhydrated patients (closed circle).

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