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Perit Dial Int 26(6): 697-704 2006
© 2006 International Society for Peritoneal Dialysis
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Clinical

RESTING ENERGY EXPENDITURE IN PERITONEAL DIALYSIS PATIENTS

Ana P. Bazanelli1, Maria A. Kamimura1, Camila Barbosa da Silva2, Carla M. Avesani1, Miriam G. Garcia Lopes1, Silvia R. Manfredi2, Sergio A. Draibe2 and Lilian Cuppari1,2

1 Nutrition Program and2 Division of Nephrology, Federal University of São Paulo, São Paulo, Brazil

Correspondence to: L. Cuppari, Rua Pedro de Toledo, 282, 04039-000, São Paulo, SP, Brazil.
lilian{at}dis.epm.br

{diamondsuit} Objectives: This study aimed to evaluate whether resting energy expenditure (REE) of patients undergoing peritoneal dialysis (PD) therapy differs from that of healthy individuals, as well as to investigate the factors associated with REE in this sample of patients.

{diamondsuit} Design: Cross-sectional study.

{diamondsuit} Setting: Dialysis Unit of the Nephrology Division, Federal University of Sao Paulo-Oswaldo Ramos Foundation, Brazil.

{diamondsuit} Subjects and Methods: The study examined the REE of 37 patients (20 males, age 44.5 ± 13 years) undergoing PD therapy. Only patients older than 18 years, on PD for at least 3 months, without catabolic illness, and with normal thyroid function were included. Patients were pair matched for age and gender with 37 healthy individuals. REE was measured by indirect calorimetry. Body composition was assessed by dual-energy x-ray absorptiometry in the patients and by bioelectrical impedance in the healthy individuals.

{diamondsuit} Results: The REE of PD patients was similar to that of pair-matched controls (1372 ± 266 and 1453 ± 252 kcal/day respectively, p = 0.13) even when adjusted for lean body mass and gender (p = 0.56). The REE of PD patients was positively correlated with lean body mass (r = 0.60, p < 0.01), fat mass (r = 0.43, p < 0.01), body mass index (r = 0.60, p < 0.01), serum glucose (r = 0.36, p < 0.05), and protein equivalent of nitrogen appearance (PNA; r = 0.42, p < 0.01). There were no correlations between REE and glucose absorption, dialysis-related parameters, C-reactive protein, and energy or protein intake by 3-day food diary. In the multiple linear regression analysis, using REE as the dependent variable, the final model showed that lean body mass and female gender were determinants of REE in PD patients (R2 = 0.44). When separate analysis by gender was performed, REE correlated directly with body fat in female patients (r = 0.70, p < 0.01) but not in male patients (r = 0.29, p = 0.21). On the other hand, lean body mass was significantly correlated with REE in male patients (r = 0.78, p < 0.01) but not in female patients (r = 0.47, p = 0.06).

{diamondsuit} Conclusions: This study showed that REE of PD patients did not differ from that of healthy individuals. The strong association between body fat and REE in female patients remains to be further investigated.

KEY WORDS: Chronic kidney disease; resting energy expenditure.

Received 30 January 2006; accepted 1 May 2006.






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