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Original Paper

Poor Agreement between Predictive Equations of Energy Expenditure and Measured Energy Expenditure in Critically Ill Acute Kidney Injury Patients

de Góes C.R.b · Berbel-Bufarah M.N.b · Sanches A.C.S.b · Xavier P.S.b · Balbi A.L.a · Ponce D.a

Author affiliations

aInternal Medicine Department and bNutritionists, Acute Kidney Injury Group, UNESP - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu, Brazil

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Ann Nutr Metab 2016;68:276-284

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: September 07, 2015
Accepted: May 09, 2016
Published online: June 10, 2016
Issue release date: July 2016

Number of Print Pages: 9
Number of Figures: 2
Number of Tables: 4

ISSN: 0250-6807 (Print)
eISSN: 1421-9697 (Online)

For additional information: https://www.karger.com/ANM

Abstract

Background: There are multiple equations for predicting resting energy expenditure (REE), but how accurate they are in severe acute kidney injury (AKI) patients is not clear. Our aim was to determine if predictive equations for estimated REE accurately reflect the requirements of AKI patients. Methods: We included in this prospective and observational study AKI patients AKIN-3 assessed by indirect calorimetry (IC). Bland-Altman, intraclass correlation coefficient and precision (percentagem of predicted values within 10% of measured values) were performed to compare REE by equations with REE measured by IC. Results: IC was applied in 125 AKI patients. The mean age was 62.5 ± 16.6 and 65.6% were male. Mean REE measured was 2,029.11 ± 760.4 kcal/day. There were low precision, and poor agreement between measured and predicted REE by the Harris-Benedict (HB), Mifflin, Ireton-Jones, Penn state, American College of Chest Physicians, and Faisy equations. HB without using injury factor was the least precise (18% of precision). Modified Penn state equation had the best precision, although the precision rate was only 41%. For all equations, the limits of agreement range were large leading to the potential under or overfeeding of individual patients. Conclusion: None of these equations accurately estimated measured REE in severe AKI patients and most of them underestimated energy needs.

© 2016 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: September 07, 2015
Accepted: May 09, 2016
Published online: June 10, 2016
Issue release date: July 2016

Number of Print Pages: 9
Number of Figures: 2
Number of Tables: 4

ISSN: 0250-6807 (Print)
eISSN: 1421-9697 (Online)

For additional information: https://www.karger.com/ANM


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