Study: New equations needed to calculate resting energy expenditure
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New equations for determining resting energy expenditure are needed to provide optimal nutrition care in patients after renal transplantation, according to a published study.
“Renal transplantation is the gold standard for the treatment of end-stage renal failure in terms of survival, quality of life and health care costs. Determining the resting energy expenditure (REE) is essential for planning a proper diet that provides a suitable nutrition supply,” Nilüfer Acar Tek, PhD, from the department of nutrition and dietetics at Gazi University, and colleagues wrote. “This study was planned to determine the REE with indirect calorimetry of the patients with renal transplantation and to compare them with the different equations given in the literature and to create the most appropriate energy equation for these patients.”
In a cross-sectional study, 50 patients (30 men, 21 women) aged 25 to 70 years with a functioning graft 1 year after transplant were included for analysis. REE was measured using indirect calorimeter 8 hours after fasting and compared to the predictive REE calculated by eight previously established equations.
Study results showed all predictive equations underestimated REE measurements with values varying from 27.5% (CKD equation) to 98.0% (Bernstein equation), the highest overpredicted value was 17.7% by the Schofield equation. The maximum difference was calculated by the Bernstein equation (-478 kcal) and the minimum difference observed in the Cunningham equation (-69 kcal). Further analysis found fat-free mass was the most significant variable in multiple regression analysis and a supplementary new equation based on available anthropometric measurements was generated (-1,996.8 + 19.1*height [cm] 17.2*body weight [kg]).
“Compared with other estimation equations, the newly developed equations provide the nearest predictive values for indirect calorimetry measurement,” Acar Tek and colleagues concluded. “ ... The new specic equations will enable the easy determination of energy requirements in these patients. However, there is still a need for further studies to evaluate these equations.”
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