Resting energy expenditure in chronic kidney disease: Relationship with glomerular filtration rate

A. Panesar, Rajiv Agarwal

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: The kidneys may account for up to 20% of resting energy expenditure (REE), but there is controversy regarding the relationship between severity of renal impairment and REE. Furthermore, reduction in protein intake is associated with declining glomerular filtration rate (GFR) that contributes to malnutrition. If a selective aversion to protein intake or a global reduction in food intake takes place is not known. Methods: To define the relationship between REE and its relationship to GFR, we measured REE with indirect calorimetry, GFR with iothalamate clearance, and body composition with creatinine kinetics and skinfold measurements in 16 patients with mild to moderate renal failure due to type 2 diabetes mellitus (n = 12) or glomerulonephritides (n = 4). Results: In univariate analysis, age, weight, height, body mass index, lean body mass, urine urea nitrogen but not hemoglobin or albumin correlated with REE. In multivariate analysis, lean body mass emerged as the strongest predictor of REE followed by GFR. A lower GFR was associated with a lower REE. Also, we found reduced REE, but not a fall in GFR, was associated with a fall in dietary protein intake. This supports the hypothesis that patients with CKD have no selective aversion to protein; reduction in dietary protein intake with progressive CKD is due to global reduction in food intake. Conclusions: We conclude that REE falls with declining renal function in patients with CKD. This is likely secondary to combination of reduced energy expenditure of kidneys, adaptation to decreased energy intake or alteration in cellular energy metabolism.

Original languageEnglish
Pages (from-to)360-366
Number of pages7
JournalClinical Nephrology
Volume59
Issue number5
StatePublished - May 1 2003

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Glomerular Filtration Rate
Chronic Renal Insufficiency
Energy Metabolism
Kidney
Dietary Proteins
Eating
Iothalamic Acid
Indirect Calorimetry
Proteins
Glomerulonephritis
Body Composition
Energy Intake
Malnutrition
Type 2 Diabetes Mellitus
Renal Insufficiency
Urea
Albumins
Creatinine
Hemoglobins
Body Mass Index

Keywords

  • Chronic kidney disease
  • Glomerular filtration rate
  • Resting energy expenditure
  • Skin-fold ickness

ASJC Scopus subject areas

  • Nephrology

Cite this

Resting energy expenditure in chronic kidney disease : Relationship with glomerular filtration rate. / Panesar, A.; Agarwal, Rajiv.

In: Clinical Nephrology, Vol. 59, No. 5, 01.05.2003, p. 360-366.

Research output: Contribution to journalArticle

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