Chronic Kidney Disease

CKD: Energy Requirement (2018)

• Assessment
  Is there evidence to support the use of REE equations for assessing energy requirements in adults with CKD 1-5D and post-transplant?

  • Conclusion

    The Harris and Benedict, Schofield and Mifllin St. Joer equations may not be appropriate for measuring resting energy expenditure (REE) in non-dialyzed and dialyzed CKD patients, as agreement with indirect calorimetry is inconsistent between patients and these equations tended to overestimate energy needs (four studies) compared to indirect calorimetry, though not in all cases (one study with hemodialysis (HD) participants). Novel equations created for CKD participants, particularly those on dialysis, may be more accurate for estimating energy needs in HD patients (two studies).

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Is there evidence to support the use of REE equations for assessing energy requirements in adults with CKD 1-5D and post-transplant?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Byham-Gray L, Parrott J, Ho W, Sundell M, Ikizler T. Development of a predictive energy equation for maintenance hemodialysis patients: a pilot study. Journal of Renal Nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2014; 24:32-41
      • Dias Rodrigues JC, Lamarca F, de Oliveira CL, Cuppari L, Lourenco RA, Avesani CM. Agreement between prediction equations and indirect calorimetry to estimate resting expenditure in elderly patients on hemodialysis. e-SPEN Journal 2014; 9:e91-e96
      • Kamimura M, Avesani C, Bazanelli A, Baria F, Draibe S, Cuppari L. Are prediction equations reliable for estimating resting energy expenditure in chronic kidney disease patients?. Nephrology, Dialysis, Transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 2011; 26:544-50
      • Lee S, Kim H, Kwon H, Son S, Song J, Kim M. Agreements between indirect calorimetry and prediction equations of resting energy expenditure in end-stage renal disease patients on continuous ambulatory peritoneal dialysis. Yonsei Medical Journal 2008; 49:255-64
      • Neyra R, Chen K, Sun M, Shyr Y, Hakim R, Ikizler T. Increased resting energy expenditure in patients with end-stage renal disease. JPEN. Journal of Parenteral and Enteral Nutrition 2003; 27:36-42
      • Vilar E, Machado A, Garrett A, Kozarski R, Wellsted D, Farrington K. Disease-specific predictive formulas for energy expenditure in the dialysis population. Journal of Renal Nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2014; 24:243-51
  • Search Plan and Results: CKD: Assessment: Energy Requirement (2018)