Energy Requirement of Patients Undergoing Hemodialysis: A Cross-Sectional Study in Multiple Centers

Background. Energy requirements must be estimated before nutritional care can be provided for patients undergoing hemodialysis (HD). However, the recommended caloric intake for patients has not been conclusively determined because of insufficiently large sample sizes. Method. This cross-sectional ob...

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Main Authors: Pei-Yu Wu, Yu-Tong Chen, Te-Chih Wong, Hsi-Hsien Chen, Tzen-Wen Chen, Tso-Hsiao Chen, Yung-Ho Hsu, Sheng-Jeng Peng, Ko-Lin Kuo, Szu-Chun Hung, Shwu-Huey Yang
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Biochemistry Research International
Online Access:http://dx.doi.org/10.1155/2020/2054265
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author Pei-Yu Wu
Yu-Tong Chen
Te-Chih Wong
Hsi-Hsien Chen
Tzen-Wen Chen
Tso-Hsiao Chen
Yung-Ho Hsu
Sheng-Jeng Peng
Ko-Lin Kuo
Szu-Chun Hung
Shwu-Huey Yang
author_facet Pei-Yu Wu
Yu-Tong Chen
Te-Chih Wong
Hsi-Hsien Chen
Tzen-Wen Chen
Tso-Hsiao Chen
Yung-Ho Hsu
Sheng-Jeng Peng
Ko-Lin Kuo
Szu-Chun Hung
Shwu-Huey Yang
author_sort Pei-Yu Wu
collection DOAJ
description Background. Energy requirements must be estimated before nutritional care can be provided for patients undergoing hemodialysis (HD). However, the recommended caloric intake for patients has not been conclusively determined because of insufficiently large sample sizes. Method. This cross-sectional observational study recruited patients undergoing long-term HD from multiple centers as well as people in the general population without chronic kidney disease. People from both groups were matched by sex and age. Resting energy expenditure (REE) was estimated using an indirect calorimeter. Two commonly used equations for estimating REE and daily energy requirement recommended by the National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative (K/DOQI) were chosen. Results. This study had 154 HD patients and 33 matched HD–control group pairs. Age (r = −0.36, p<0.01) and dry body weight after dialysis (r = 0.54, p<0.01) were identified as the primary factors affecting total energy expenditure (TEE). When compared with measured energy expenditure, the recommended equations for evaluating energy expenditure, namely, the Harris–Benedict, Schoenfeld, and K/DOQI-recommended equations, were biased and imprecise for HD patients of different sexes and body sizes. Moreover, the TEEs of HD patients (26.8 ± 5.5 kcal/kg/day) and the matched control patients (25.3 ± 5.1 kcal/kg/day) did not significantly differ. Conclusions. Age and dry body weight are the main factors affecting the energy expenditure of HD patients. Furthermore, predicting the energy expenditure of HD patients by measuring the energy expenditure of their sedentary counterparts in the general population with the same sex, age range, and weight may yield better results than using traditional equations for predicting TEE. In East Asian populations, the TEE values were 32 and 30 kcal/kg dry weight for those aged <65 and ≥65 years, respectively. Future prospective cohort studies with larger sample sizes are needed.
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spelling doaj-art-2e7b0bae9f294526ba6c412c5de2155b2025-08-20T02:38:50ZengWileyBiochemistry Research International2090-22472090-22552020-01-01202010.1155/2020/20542652054265Energy Requirement of Patients Undergoing Hemodialysis: A Cross-Sectional Study in Multiple CentersPei-Yu Wu0Yu-Tong Chen1Te-Chih Wong2Hsi-Hsien Chen3Tzen-Wen Chen4Tso-Hsiao Chen5Yung-Ho Hsu6Sheng-Jeng Peng7Ko-Lin Kuo8Szu-Chun Hung9Shwu-Huey Yang10School of Nutrition and Health Sciences, Taipei Medical University, Taipei, TaiwanSchool of Nutrition and Health Sciences, Taipei Medical University, Taipei, TaiwanDepartment of Nutrition and Health Sciences, Chinese Culture University, Taipei, TaiwanDepartment of Nephrology, Taipei Medical University Hospital, Taipei, TaiwanSchool of Medicine, Taipei Medical University, Taipei, TaiwanDepartment of Nephrology, Wan Fang Medical Center, Taipei, TaiwanDivision of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, TaiwanDivision of Nephrology, Cathay General Hospital, Taipei, TaiwanDivision of Nephrology, Taipei Tzu-Chi Hospital, New Taipei City, TaiwanDivision of Nephrology, Taipei Tzu-Chi Hospital, New Taipei City, TaiwanSchool of Nutrition and Health Sciences, Taipei Medical University, Taipei, TaiwanBackground. Energy requirements must be estimated before nutritional care can be provided for patients undergoing hemodialysis (HD). However, the recommended caloric intake for patients has not been conclusively determined because of insufficiently large sample sizes. Method. This cross-sectional observational study recruited patients undergoing long-term HD from multiple centers as well as people in the general population without chronic kidney disease. People from both groups were matched by sex and age. Resting energy expenditure (REE) was estimated using an indirect calorimeter. Two commonly used equations for estimating REE and daily energy requirement recommended by the National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative (K/DOQI) were chosen. Results. This study had 154 HD patients and 33 matched HD–control group pairs. Age (r = −0.36, p<0.01) and dry body weight after dialysis (r = 0.54, p<0.01) were identified as the primary factors affecting total energy expenditure (TEE). When compared with measured energy expenditure, the recommended equations for evaluating energy expenditure, namely, the Harris–Benedict, Schoenfeld, and K/DOQI-recommended equations, were biased and imprecise for HD patients of different sexes and body sizes. Moreover, the TEEs of HD patients (26.8 ± 5.5 kcal/kg/day) and the matched control patients (25.3 ± 5.1 kcal/kg/day) did not significantly differ. Conclusions. Age and dry body weight are the main factors affecting the energy expenditure of HD patients. Furthermore, predicting the energy expenditure of HD patients by measuring the energy expenditure of their sedentary counterparts in the general population with the same sex, age range, and weight may yield better results than using traditional equations for predicting TEE. In East Asian populations, the TEE values were 32 and 30 kcal/kg dry weight for those aged <65 and ≥65 years, respectively. Future prospective cohort studies with larger sample sizes are needed.http://dx.doi.org/10.1155/2020/2054265
spellingShingle Pei-Yu Wu
Yu-Tong Chen
Te-Chih Wong
Hsi-Hsien Chen
Tzen-Wen Chen
Tso-Hsiao Chen
Yung-Ho Hsu
Sheng-Jeng Peng
Ko-Lin Kuo
Szu-Chun Hung
Shwu-Huey Yang
Energy Requirement of Patients Undergoing Hemodialysis: A Cross-Sectional Study in Multiple Centers
Biochemistry Research International
title Energy Requirement of Patients Undergoing Hemodialysis: A Cross-Sectional Study in Multiple Centers
title_full Energy Requirement of Patients Undergoing Hemodialysis: A Cross-Sectional Study in Multiple Centers
title_fullStr Energy Requirement of Patients Undergoing Hemodialysis: A Cross-Sectional Study in Multiple Centers
title_full_unstemmed Energy Requirement of Patients Undergoing Hemodialysis: A Cross-Sectional Study in Multiple Centers
title_short Energy Requirement of Patients Undergoing Hemodialysis: A Cross-Sectional Study in Multiple Centers
title_sort energy requirement of patients undergoing hemodialysis a cross sectional study in multiple centers
url http://dx.doi.org/10.1155/2020/2054265
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