Caloric requirements in the hemodialysis subject

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Virginia Polytechnic Institute and State University

The nutritional needs of the renal patient vary as the renal function decreases. Little information exists concerning energy requirements for patients on hemodialysis. Renal failure has been called a wasting disease as evidenced by decreased body weight, body fat, arm circumference and serum proteins. This research was designed to help precisely define energy requirements for the hemodialysis subject. Resting energy expenditure (REE) was measured by indirect calorimetry in 17 male hemodialysis subjects whose mean age was 55 years at the Veterans Administration Medical Center in Hampton, Va. The Beckman MMC Horizon System, a portable device which permits the determination of heat production from gas exchange, oxygen consumption and carbon dioxide production was used.

By regression analysis, the measured REE was compared to the basal energy expenditure (BEE): the ideal weight based on the Metropolitan Life Insurance tables, the current weight taken on day of indirect calorimetry, a non-dialysis day, and the post dialysis weight taken immediately after dialysis. A correlation analysis of the dependent variable, IEE, with the current, ideal and post dialysis BBE variable resulted in correlation coefficients of .3783, .0003, and .3946 respectively. None of these correlation coefficients were significantly correlated with the REE. The post dialysis variable had the highest correlation coefficient, and thus the strongest relationship to the REE. While any of the weights studied could be used to determine energy needs for the hemodialysis subject, post dialysis weight may be the most desirable choice.