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Does intra-abdominal fluid increase the resting energy expenditure?
E J Zarling1, A Grande, J Hano
1Department of Medicine, Loyola University Medical Center, Maywood, Illinois, USA.
Nutrition (Burbank, Los Angeles County, Calif.)
|November 14, 1997
Summary
Intra-abdominal fluid in peritoneal dialysis patients does not impact resting energy expenditure (REE). This study found that fluid accumulation is metabolically inactive, contrary to some previous assumptions.
Area of Science:
- Clinical Nutrition
- Metabolic Studies
- Renal Medicine
Background:
- Caloric needs in patients with intra-abdominal fluid are typically estimated using dry weight.
- Intra-abdominal fluid has been presumed metabolically inactive.
- Recent findings suggest ascites may influence metabolic activity.
Purpose of the Study:
- To investigate the impact of intra-abdominal fluid on resting energy expenditure (REE).
- To assess the effect of intra-abdominal fluid on apparent lean body mass.
- To determine if intra-abdominal fluid is metabolically active in patients on peritoneal dialysis.
Main Methods:
- Indirect calorimetry was used to measure REE in 10 stable peritoneal dialysis patients.
- Body composition was assessed using bioelectric impedance analysis.
- Measurements were taken in both empty and fluid-filled abdominal states.
Main Results:
- Carbon dioxide production (VCO2) was significantly higher in the fluid-filled state (P < 0.02).
- Resting energy expenditure (REE) showed a significant increase in the fluid-filled state (P < 0.05).
- Body fat, lean body mass, and total water estimates remained unaffected by intra-abdominal fluid.
Conclusions:
- Intra-abdominal fluid does not significantly alter measured resting energy expenditure.
- The fluid accumulation in this context can be considered metabolically inactive.
- Current methods of estimating caloric needs based on dry weight remain appropriate.
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