Resting energy expenditure in pre-dialysis diabetic patients

Resting energy expenditure in pre-dialysis diabetic patients

Author Avesani, Carla Maria Autor UNIFESP Google Scholar
Cuppari, Lilian Autor UNIFESP Google Scholar
Silva, Antonio Carlos Autor UNIFESP Google Scholar
Sigulem, Dirce Maria Autor UNIFESP Google Scholar
Cendoroglo, Miguel Autor UNIFESP Google Scholar
Sesso, Ricardo Autor UNIFESP Google Scholar
Draibe, Sergio Antonio Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Background. the metabolic derangements of diabetes mellitus (DM) associated with those of chronic renal failure (CRF) may interfere with the energy and protein balance of patients with both diseases. the aim of this study was to verify whether the resting energy expenditure (REE) of non-dialysis chronic renal failure diabetic patients differs from that of chronic renal failure patients without DM.Methods. REE was measured by indirect calorimetry in 24 CRF diabetic patients (CRF diabetes group), matched for age, gender, and degree of renal impairment to 24 CRF patients without DM (CRF control group).Results. the CRF diabetes group had a significantly higher REE (1538 +/- 230 kcal/day) than the CRF control group (1339 +/- 315 kcal/day, P=0.009). This difference was maintained even when the REE was adjusted for lean body mass (LBM; 30.3 +/- 4.3 vs 26.3 +/- 5.4 kcal/kg LBM/day, P=0.004). Mean protein intake was significantly higher in the CRF diabetes than in the CRF control group (0.89 +/- 9.20 vs 0.76 +/- 0.25 g/kg/day, P=0.02). Mean protein equivalent of nitrogen appearance (PNA) was also significantly higher in the CRF diabetes patients (1.21 +/- 0.31 vs 1.03 +/-0.22 g/kg/day, P=0.02), reflecting a higher protein intake and/or elevated protein breakdown. Accordingly, REE was directly correlated with PNA mainly in the CRF diabetes group (r = 0.57, P < 0.003).Conclusion. Metabolic disturbances of poorly controlled DM may account for the higher REE observed in the CRF diabetes group. the role of the apparently higher protein breakdown in this increased REE remains to be clarified.
Keywords chronic renal failure
indirect calorimetry
protein intake
Language English
Date 2001-03-01
Published in Nephrology Dialysis Transplantation. Oxford: Oxford Univ Press, v. 16, n. 3, p. 556-560, 2001.
ISSN 0931-0509 (Sherpa/Romeo, impact factor)
Publisher Oxford Univ Press
Extent 556-560
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000167549300020

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