Novel equation for estimating resting energy expenditure in patients with chronic kidney disease. Issue 6 (10th March 2021)

• Record Type: Journal Article
• Authors: Xu, Xiao; Yang, Zhikai; Ma, Tiantian; Li, Ziqian; Chen, Yuan; Zheng, Yingdong; Dong, Jie
• Is Part Of: American journal of clinical nutrition. Volume 113:Issue 6(2021)
• Page Start: 1647
• Page End: 1656
• Publication Date: 2021-03-10
• Subjects: chronic kidney disease -- resting energy expenditure -- indirect calorimetry -- prediction equation -- energy requirement; Diet therapy -- Periodicals; Nutrition -- Periodicals; Dietetics -- Periodicals; 613.205
• DOI: 10.1093/ajcn/nqaa431
• Languages: English
• ISSNs: 0002-9165

Abstract

ABSTRACT: Background: In chronic kidney disease (CKD), determining energy expenditure is the precondition for recommending energy intake in nutrition management. Objectives: We aimed to develop and validate a resting energy expenditure (REE) equation for patients with CKD. Methods: This cross-sectional study enrolled 300 patients with CKD (stages 3–5) according to inclusion and exclusion criteria. Stepwise linear regression analysis was used to derive a new REE equation (eREE-CKD) according to actual REE (aREE) measured using indirect calorimetry in the development dataset. The eREE-CKD value was then validated with aREE in the validation dataset and compared with values from existing equations obtained in general populations, namely, the Harris–Benedict, Mifflin, WHO, and Schofield equations in terms of bias, precision, and accuracy. Results: The eREE-CKD equation: eREE-CKD (kcal) = (1 if male; 0 if female) × 106.0 − [1 if diabetes mellitus (DM); 0 if non-DM] × 51.6 − 4.7 × age (y) + 13.1 × weight (kg) + 645.5 ( R 2 = 0.779). The bias, precision, and accuracy (percentage of estimates that differed >20% from the measured REE) of the eREE-CKD equation were −0.4 (IQR: −29.8, 23.8) kcal, 98.4 (IQR: 79.5, 116.6) kcal, and 5.4%, respectively with indirect calorimetry as the reference method. Both bias and precision of the eREE-CKD were significantly better than the Harris–Benedict, WHO, and Schofield equations ( P < 0.001) and similar to the Mifflin equation ( P = 0.125 for bias and 0.268 for precision). Accuracy of the eREE-CKD was significantly better than the Harris–Benedict, WHO, Mifflin, and Schofield equations ( P < 0.001). Bias, precision, and accuracy of the eREE-CKD equation were consistent when applied to subgroups categorized according to high-sensitivity C-reactive protein concentrations and CKD stages, respectively. Conclusions: The eREE-CKD equation using age, sex, weight, and DM data could serve as a reliable tool for estimating REE in patients with CKD. This trial was registered at clinicaltrials.gov as NCT03377413.