Resting energy expenditure of chronic kidney disease patients: Influence of renal function and subclinical inflammation

Resting energy expenditure of chronic kidney disease patients: Influence of renal function and subclinical inflammation

Autor Avesani, C. M. Google Scholar
Draibe, S. A. Google Scholar
Kamimura, Maria Ayako Autor UNIFESP Google Scholar
Colugnati, FAB Google Scholar
Cuppari, L. Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo Background: the resting energy expenditure (REE) of patients with chronic kidney disease (CKD) might be influenced by the degree of renal function and by a subclinical inflammatory condition. the aim of this study is to evaluate the impact of these 2 variables on the REE of patients with CKD. Methods: A cross-sectional study was performed on 91 nondialyzed and nondiabetic patients with CKD with no clinical signs of inflammation. Patients were divided into quartiles of creatinine clearance (CrCl) and tertiles of C-reactive protein (CRP) level. REE was measured by means of indirect calorimetry, and the presence of a subclinical inflammatory condition was assessed by means of serum CRP concentration. Results: CrCl interquartile ranges calculated were: quartile 1 (CrCl :5 18 mL/min [less than or equal to0.30 mL/s]; n = 24); quartile 2 (CrCl, 19 to 29 mL/min [0.31 to 0.48 mL/s]; n = 22); quartile 3 (CrCl, 30 to 42 mL/min [0.49 to 0.70 mL/s]; n = 23), and quartile 4 (CrCl greater than or equal to 43 mL/min [greater than or equal to0.71 mL/s]; n = 22). Nonadjusted REE and REE adjusted for sex, age, and lean body mass did not differ among the 4 CrCl quartiles. the following ranges were calculated for CRP tertiles: tertile 1 (CRP less than or equal to 0.14 mg/dL; n = 30), tertile 2 (CRP, 0.15 to 0.49 mg/dL; n = 31), and tertile 3 (CRP greater than or equal to 0.50 mg/dL; n = 30). the nonadjusted REE in CRP tertile 3 was significantly greater than those in tertiles 1 and 2. REE adjusted for sex, age, and lean body mass was greater in CRP tertile 3 than tertile 1, a difference equivalent to 123.7 kcal/d (P = 0.003; 95% confidence interval, 42.9 to 204.5). A borderline difference was observed between CRP tertiles 3 and 2. When analyzing the entire group, REE did not correlate with either serum creatinine level or CrCl, and a borderline correlation between REE and log of CRP was observed (r = 0.19; P = 0.07). Conclusion: This study suggests that REE is not influenced by degree of renal function, but it may be elevated during a condition of subclinical inflammation.
Palavra-chave chronic kidney disease (CKD)
resting energy expenditure (REE)
renal function
inflammation
Idioma Inglês
Data de publicação 2004-12-01
Publicado em American Journal of Kidney Diseases. Philadelphia: W B Saunders Co, v. 44, n. 6, p. 1008-1016, 2004.
ISSN 0272-6386 (Sherpa/Romeo, fator de impacto)
Publicador W B Saunders Co
Extensão 1008-1016
Fonte http://dx.doi.org/10.1053/j.ajkd.2004.08.023
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000225590700006
Endereço permanente http://repositorio.unifesp.br/handle/11600/28040

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