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KMID : 0311120080490020255
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Yonsei Medical Journal
2008 Volume.49 No. 2 p.255 ~ p.264
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Agreements between Indirect Calorimetry and Prediction Equations of Resting Energy Expenditure in End-Stage Renal Disease Patients on Continuous Ambulatory Peritoneal Dialysis
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Lee Seoung-Woo
Son Sook-Mee
Song Joon-Ho
Kim Moon-Jae
Kim Hyo-Jung
Kwon Hei-Kyung
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Abstract
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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.
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KEYWORD
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Energy metabolism, chronic kidney failure, continuous ambulatory peritoneal dialysis
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