Resting energy expenditure during hemodialysis

Česká verzia

Authors: M. Fořtová ¹; S. Dusilová Sulková ^1,2; J. Horáček ³; F. Lopot ¹; T. Zima ⁴; J. Bláha ¹; V. Bednářová ¹; V. Polakovič ¹
Authors place of work: Interní oddělení Strahov 1. lékařské fakulty UK a VFN, Praha, přednosta prim. MUDr. Vladimír Polakovič, MBA ¹; I. interní klinika 3. lékařské fakulty UK a FN Královské Vinohrady, Praha, přednosta prof. MUDr. Jiří Horák, CSc. ²; II. interní klinika Lékařské fakulty UK a FN, Hradec Králové, přednosta prof. MUDr. Jaroslav Malý, CSc. ³; Ústav klinické biochemie a laboratorní diagnostiky 1. lékařské fakulty UK a VFN, Praha, přednosta prof. MUDr. Tomáš Zima, DrSc., MBA ⁴
Published in the journal: Vnitř Lék 2006; 52(1): 26-33
Category: Original Contributions

Summary

Very few studies have so far reported about resting energy expenditure (REE) in chronic renal failure and there is no information available on REE during hemodialysis (HD). Hypothetically, we can expect an increase in REE during HD procedure (due to the inflammatory response to extracorporeal blood circuit). However, such increase in REE could be modified by thermal balance of the procedure. In our study, REE was measured by indirect calorimetry (Deltatrac Datex) in a group of 13 HD patients (7 males and 6 females, mean age 59.8 ± 13.5 years). In each patient, REE was assessed during two HD sessions: one isothermic and one thermoneutral. All other HD parameters were kept constant. The control group consisted of 14 healthy subjects (4 males and 10 females, mean age 41.3 ± 20.5 years) with normal renal function. There was a significant difference in thermal balance between the two HD settings: –199 kJ/HD in isothermic and –4kJ/HD in thermoneutral HD sessions (p < 0.01). Measured REE values obtained in HD patients before HD session (7 316 ± 919 kJ/day/1.73 m²) did not differ significantly from those of the healthy controls (7 264 ± 1 016 kJ/day/1.73 m²). Similarly, there was no significant difference in calculated EE values (Harris- Benedict equation). In the 10^th minute of the HD session, there was a slight, transitory decrease in REE (mean decrease by 3.2 % during isothermic and by 2.8 % during thermoneutral HD session, ns). In the 70^th minute, REE returned to pre-dialysis values. After a light meal in the 110^th minute REE increased by 8 % during isothermic and by 6.3 % during thermoneutral HD session. At the end of the HD session (i.e. in the 215^th minute) REE again returned to pre-dialysis values. Intra-dialysis changes in REE were similar in both isothermic and thermoneutral HD sessions. The results of our study did not confirm the expected influence of HD procedure on REE in the two different thermal HD settings. We conclude that there is no significant difference between REE in HD patients and healthy controls and that REE values are not significantly influenced by hemodialysis procedure.

Key words:
resting energy expenditure – chronic renal failure – hemodialysis – indirect calorimetry – energy balance

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