Estimating energy requirements for children with renal disease: a comparison of methods

The resting energy expenditure of children with renal disease is unknown. We assessed resting energy expenditure using indirect calorimetry in a group of 16 children aged 3.6 to 15.7 years (mean +/- standard deviation = 9.4 +/- 4.6 years) with renal disease and compared these results with standard prediction formulas. Measured resting energy expenditure was compared with norms predicted from the Mayo Clinic standards for children 6 years of age and older, the combined data reported by Passmore, and the most recent equations provided by the Food and Agriculture Organization/World Health Organization/United Nations University (FAO/WHO/UNU). The Mayo Clinic standards overpredicted resting energy expenditure in 7 of 10 subjects, whereas the Passmore standards and the FAO/WHO standards underpredicted resting energy expenditure in 10 of 16 and 9 of 16 subjects, respectively. When adjusted for the age of the subject, our findings indicate that all three standards are useful for predicting resting energy expenditure in children 6 years and older with renal disease, but no current standard adequately predicts the resting energy expenditure of children less than 6 years of age with renal disease.