Nutrition Program, Universidade Federal de São Paulo, São Paulo, Brazil; Hospital do Rim-Fundação Oswaldo Ramos, São Paulo, Brazil.
Nutrition Institute, Department of Applied Nutrition, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil; Division of Renal Medicine-Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Solna, Sweden.
Nutrition. 2019 Nov-Dec;67-68:110527. doi: 10.1016/j.nut.2019.06.008. Epub 2019 Jun 14.
The aims of this study were to develop and validate a resting energy expenditure (REE) predictive equation in a cohort of patients on dialysis and to test the accuracy of two previously developed specific equations to estimate REE of these patients.
A database with REE measured by indirect calorimetry (IC) of 189 patients on hemodialysis and peritoneal dialysis was used to develop and validate the new equation. The sample including only patients on hemodialysis (n = 131) was used to test the accuracy of the specific REE dialysis equations by Vilar and Byham-Gray.
Multiple regression analysis generated two equations: REE (kcal/d) = 957.02 - 8.08 × age + 11.07 × body weight + 136.4 (if men) (R = 0.515) (1) REE (kcal/d) = 624.6-4.8 × age + 20.6 × fat-free, ass-fat-free mass-8.65 (if men) (R = 0.512) (2) In the validation group, REE by both equations did not differ from the REE measured by IC. No bias was found in the Bland-Altman analysis and the intraclass correlation coefficient and P20 test showed good reliability with measured REE. Vilar's equation overestimated REE; whereas REE generated by Byham-Gray's equation did not differ from measured REE. Proportional and systematic biases were significant for both equations.
The new equations developed showed good accuracy and can be valuable to estimate energy needs of patients on dialysis. Byham-Gray's and Vilar's equations presented low to moderate performance to estimate REE of the patients on dialysis.
本研究旨在为透析患者开发和验证静息能量消耗（REE）预测方程，并检验两种先前开发的特定方程估计这些患者 REE 的准确性。
使用间接测热法（IC）测量的 189 例血液透析和腹膜透析患者的 REE 数据库来开发和验证新方程。仅包括血液透析患者的样本（n=131）用于测试 Vilar 和 Byham-Gray 的特定 REE 透析方程的准确性。
多元回归分析生成了两个方程：REE（千卡/天）=957.02-8.08×年龄+11.07×体重+136.4（男性）（R=0.515）（1）REE（千卡/天）=624.6-4.8×年龄+20.6×去脂体质量-8.65（男性）（R=0.512）（2）在验证组中，两种方程的 REE 与 IC 测量的 REE 无差异。Bland-Altman 分析未发现偏差，组内相关系数和 P20 检验显示与测量的 REE 具有良好的可靠性。Vilar 方程高估了 REE；而 Byham-Gray 方程生成的 REE 与测量的 REE 无差异。两种方程均存在比例和系统偏差。
开发的新方程具有良好的准确性，可用于估计透析患者的能量需求。Byham-Gray 和 Vilar 的方程对估计透析患者的 REE 表现出低到中等的性能。
