[Resting metabolic rate estimated by bioelectrical impedance analysis and its determinants in maintenance...

Objective: To explore the level of resting energy expenditure (REE) estimated by bioelectrical impedance analysis and the association of resting metabolic rate (RMR) with clinical related factors, and provide new ideas for improving protein energy wasting (PEW) in maintenance hemodialysis (MHD) patients. Methods: Seven hundred and sixty-five subjects receiving MHD between July 2015 and September 2016 in 11 hemodialysis centers in Guizhou province were enrolled in this cross-sectional study. Bioelectrical impedance analysis was used to measure RMR and body composition, such as lean body mass, fat mass and body cell mass (BCM). Baseline characteristics, routine blood test indexes and biochemical data of hemodialysis patients were collected. The level of RMR and body composition in hemodialysis patients was compared by gender grouping. Then the patients were divided into four groups according to the cutoff value of RMR quartile. Spearman correlation analysis and multiple linear regression analysis were used to analyze the relationships between RMR and clinical related factors. Results: The average age of MHD patients was (54.96±15.78) years and the duriation of dialysis was (42.3±9.0) months. The level of RMR in male patients (474 cases, 61.96%) was significantly higher than that in female patients [1 591(1 444, 1 764) kcal/d vs 1 226 (1 104, 1 354) kcal/d, P<0.001]. However, this significant difference of RMR between different genders disappeared after adjusting for lean body mass (P=0.193). Multiple linear regression analysis showed that RMR was positively correlated with body surface area (β=0.817) and lactate dehydrogenase (LDH) (β=0.198), and negatively correlated with age (β=-0.141), all P<0.05. Conclusion: RMR levels in patients with maintenance hemodialysis are associated with lactate dehydrogenase level, which may become a new index to evaluate energy consumption.