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Background Estimating energy requirements ER is crucial for nutritional attention to chronic kidney disease CKD patients Current guidelines recommend measuring ER with indirect calorimetry IC when possible Due to clinical settings the use of simple formulas is preferred Few studies have modeled equations for estimating ER for CKD Nevertheless variables of interest such as nutritional status and strength have not been explored in these models This study aimed to develop and validate a model for estimating REE in patients with CKD stages 3 5 who were not receiving renal replacement therapy RTT using clinical variables and comparing it with indirect calorimetry as the gold standard Methods In this study 80 patients with CKD participated Indirect calorimetry IC was performed in all patients The calorimeter analyzed metabolic measurements every minute for 15 min after autocalibration with barometric pressure temperature and humidity Bioelectrical Impedance Analysis BIA was performed Fat-free mass FFM was registered among other bioelectrical components Handgrip strength HGS was evaluated and an average of 3 repetitions was recorded Nutritional status was assessed with the subjective global assessment SGA Patients categorized as B or C were then considered as having malnutrition Results We analyzed 71 patients and 3 models were generated Model 1a included FFM Model 2a included weight Model 3c included handgrip strength HGS All other variables were stepwise computer-selected with a p 0 01 significance level Malnutrition was consistently associated with ER among other clinical variables in all models p 0 05 The model that included BIA-FFM had R2 adjusted 0 46 while the model that included weight Kg had an adjusted R2 adjusted 0 44 The models had moderate concordance LC 0 60 0 65 with the gold standard whereas other energy expenditure estimation equations had LC 0 36 and 0 55 with indirect calorimetry Using these previously validated equations as a reference our models had concordance values ranging from 0 66 to 0 80 with them Conclusion Models incorporating nutritional status and other clinical variables such as weight FFM comorbidities gender and age have a moderate agreement with REE The agreement between our models and others previously validated for the CKD patient is good however the agreement between the latter and IC measurements is moderate The KDOQI lowest recommendation 25 Kcals kg body weight considering the 22 difference with respect to the IC for total energy expenditure rather than for REE

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Nutritional Status and Other Clinical Variables Are Associated to the Resting Energy Expenditure in Patients With Chroni...

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