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Scapellato, Giuseppe, Jackson, Helena and Illingworth, Sarah (2025) Investigating energy requirements and nutritional status in haemodialysis patients via indirect calorimetry–are current predictive equations reliable? Journal of Kidney Care, 10 (Sup5). S18-S29. ISSN 2397-9542
Up to 54% of haemodialysis (HD) patients are malnourished. Adequate nutrition requires a correct determination of resting energy expenditure (REE). This audit evaluates the use of the indirect calorimetry (IC) as part of routine dietetic care for HD patients. Ten HD patients had REE measured (mREE) before and after HD using IC. Predicted REE from Parenteral & Enteral Nutrition Specialist Group (PENG) equations (dry weight [DW]: 24 kcal/kg, fat-free mass (FFM): 35 kcal/kg) were compared. mREE closely matched PENG DW predictions [1812±386 vs 1992±729 kcal/day, (mean±SD), p=0.6983], but significantly differed from PENG FFM prediction (1446±462 kcal/day, p=0.0090). Four mREEs matched PENG DW predictions (90–110% adequacy), only two mREEs matched PENG FFM predictions. Bland-Altman analysis showed wide limits of agreement. No REE difference was observed pre-HD (1798±420 kcal/day) and post-HD (1825±367 kcal/day, p=0.6274). IC is a practical tool for assessing REE in HD patients. PENG DW equation better predicted REE than FFM equation.
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