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dc.contributor.authorVilar, Enric
dc.contributor.authorMachado, Ashwini
dc.contributor.authorGarrett, Andrew
dc.contributor.authorKozarski, Robert
dc.contributor.authorWellsted, D.
dc.contributor.authorFarrington, Ken
dc.date.accessioned2015-03-17T15:48:38Z
dc.date.available2015-03-17T15:48:38Z
dc.date.issued2014-04-28
dc.identifier.citationVilar , E , Machado , A , Garrett , A , Kozarski , R , Wellsted , D & Farrington , K 2014 , ' Disease-specific predictive formulas for energy expenditure in the dialysis population ' , Journal of Renal Nutrition , vol. 24 , no. 4 , pp. 243-51 . https://doi.org/10.1053/j.jrn.2014.03.001
dc.identifier.issn1051-2276
dc.identifier.otherPURE: 8230153
dc.identifier.otherPURE UUID: befe083d-5b08-48c2-909c-9969ad589219
dc.identifier.otherPubMed: 24788307
dc.identifier.otherScopus: 84902553809
dc.identifier.urihttp://hdl.handle.net/2299/15635
dc.descriptionCopyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
dc.description.abstractOBJECTIVE: Metabolic rate is poorly understood in advanced kidney disease because direct measurement is expensive and time-consuming. Predictive equations for resting energy expenditure (REE) are needed based on simple bedside parameters. Algorithms derived for normal individuals may not be valid in the renal population. We aimed to develop predictive equations for REE specifically for the dialysis population.DESIGN: Two-hundred subjects on maintenance dialysis underwent a comprehensive metabolic assessment including REE from indirect calorimetry. Parameters predicting REE were identified, and regression equations developed and validated in 20 separate subjects.RESULTS: Mean REE was 1,658 ± 317 kCal/day (males) and 1,380 ± 287 kCal/day (females). Weight and height correlated positively with REE (r(2) = 0.54 and 0.31) and negatively with age older than 65 years (r(2) = 0.18). The energy cost of a unitary kilogram of body weight increased nonlinearly for lower body mass index (BMI). Existing equations derived in normal individuals underestimated REE (bias 50-114 kCal/day for 3 equations). The novel derived equation was REE(kCal/day) = -2.497·Age·Factorage+0.011·height(2.023) + 83.573·Weight(0.6291) + 68.171·Factorsex, where Factorage = 1 if 65 years or older and 0 if younger than 65, and Factorsex = 1 if male and 0 if female. This algorithm performed at least as well as those developed for normals in terms of limits of agreement and reduced bias. In validation with the Bland-Altman technique, bias was not significant for our algorithm (-22 ± 96 kCal/day). The 95% limits of agreement were +380 to -424 kCal/day.CONCLUSION: Existing equations for REE derived from normal individuals are not valid in the dialysis population. The relatively increased REE in those with low BMI implies the need for higher dialysis doses in this subgroup. This disease-specific algorithm may be useful clinically and as a research tool to predict REE.en
dc.format.extent9
dc.language.isoeng
dc.relation.ispartofJournal of Renal Nutrition
dc.subjectAged
dc.subjectAlgorithms
dc.subjectBasal Metabolism
dc.subjectBody Mass Index
dc.subjectBody Weight
dc.subjectCalorimetry, Indirect
dc.subjectCross-Sectional Studies
dc.subjectElectric Impedance
dc.subjectEnergy Intake
dc.subjectFemale
dc.subjectFood, Formulated
dc.subjectHumans
dc.subjectLinear Models
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectMotor Activity
dc.subjectNutritional Requirements
dc.subjectPredictive Value of Tests
dc.subjectProspective Studies
dc.subjectRenal Dialysis
dc.subjectReproducibility of Results
dc.titleDisease-specific predictive formulas for energy expenditure in the dialysis populationen
dc.contributor.institutionCentre for Postgraduate Medicine
dc.contributor.institutionSchool of Life and Medical Sciences
dc.contributor.institutionHealth & Human Sciences Research Institute
dc.contributor.institutionDepartment of Psychology
dc.contributor.institutionPsychology
dc.contributor.institutionCentre for Lifespan and Chronic Illness Research
dc.contributor.institutionHealth and Clinical Psychology group
dc.contributor.institutionHealth Services and Medicine
dc.contributor.institutionBehaviour Change in Health and Business
dc.contributor.institutionPostgraduate Medicine
dc.contributor.institutionPharmacology and Clinical Science Research
dc.description.statusPeer reviewed
dc.relation.schoolSchool of Life and Medical Sciences
dcterms.dateAccepted2014-04-28
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1053/j.jrn.2014.03.001
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue


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