Energy requirements in chronic kidney disease without dialysis are similar to that of healthy individuals and are influenced by age, sex, and physical activity. Resting metabolic rates were similar for patients with chronic kidney disease and controls by direct and indirect calorimetry in one cohort study and one cross-sectional study. Nitrogen balance studies using <0.8 g protein/kg/IBW [the Recommended Dietary Allowance (RDA) for protein] reported a neutral or positive nitrogen balance when energy intakes were 35 to 45 kcal/kg/IBW and a negative nitrogen balance when energy intakes were 15 to 25 kcal/kg/IBW. Therefore, energy intakes should be greater in patients following diets containing less than the RDA for protein.
