Resting energy expenditure: a valuable predictor for KT/Vurea in peritoneal dialysis patients


The objective of this study was to identify an effective method for predicting small-molecule solute removal at the commencement of or before peritoneal dialysis (PD).

The PD patients with a dialysis delivery of 8 L/d and a residual kidney function (RKF) ≤ 5 mL/min were enrolled in the study. Fat-free lean body mass (FFM) and resting energy expenditure (REE) were measured using bioelectrical impedance (BIA). A receiver operating characteristic (ROC) curve was drawn to determine the threshold value for REE. The patients were divided into two groups, group A (lower REE) and group B (higher REE), based on their REE value.

In total, 164 PD patients were enrolled between April 2013 and February 2015. REE was positively correlated with serum creatinine (Scr), blood urea nitrogen (BUN), blood uric acid (UA), body mass index (BMI), and body surface area (BSA) and negatively correlated with total KT/V_urea (KT/V) and hemoglobin (Hb). REE (HR = 0.987, 95% CI = 0.975 - 1.000, p = 0.044) was the only predictor for KT/V. When REE was less than 1469.2 kal/d, it was easier to achieve the target KT/V. The patients in group B had significantly larger body size than those in group A; however, Hb level and total KT/V for group B were significantly lower than those for group A.

REE may be a helpful indicator for choosing a suitable dialysis modality for patients with end-stage renal disease (ESRD) and for improving the prognosis after PD.
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