Inflammation is associated with increased energy expenditure in patients with chronic kidney disease

Inflammation is associated with increased energy expenditure in patients with chronic kidney disease

Author Utaka, Simone Autor UNIFESP Google Scholar
Avesani, Carla Maria Autor UNIFESP Google Scholar
Draibe, Sergio Antonio Autor UNIFESP Google Scholar
Kamimura, Maria Ayako Autor UNIFESP Google Scholar
Andreoni, Solange Autor UNIFESP Google Scholar
Cuppari, Lilian Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Background: Inflammation, a clinical condition observed in patients with chronic kidney disease (CKD), may be related to increased resting energy expenditure (REE).Objectives: The main objective was to investigate the relation between inflammation and REE in patients with CKD who are not undergoing dialysis. We also aimed to analyze whether a decrease in C-reactive protein (CRP) would result in a reduction in REE.Design: This study enrolled 132 patients with CKD who were not undergoing dialysis, who had creatinine clearance from 5 to 65 mL (.) min(-1) (.) 1.73 m(-2), and who were 53.6 +/- 16 y old; 82 (62.1%) were men. Twenty-nine patients had clinical signs of infection. REE was measured by using indirect calorimetry, and inflammation was evaluated by using high-sensitivity CRP measurement. Patients were divided according to tertiles of CRP with the following intertertile ranges: first tertile, CRP <= 0.14 mg/dL (n = 43); second tertile, CRP 0.15- 0.59 mg/dL (n = 46); and third tertile, CRP >= 0.60 mg/dL (n = 43). REE was measured before and after treatment in 10 patients who had inflammation or infection.Results: After adjustment for age, sex, and lean body mass, the REE of the third (1395 kcal/d; P = 0.02) and second (1355 kcal/d; P = 0.04) tertiles was significantly higher than that of the first tertile (1286 kcal/d). In the multiple linear regression analysis (n = 132), the independent determinants of REE were lean body mass, CRP, and age (R-2 = 0.55). After treatment of infection in a subgroup of 10 patients, it was observed that a significant reduction in CRP concentration was accompanied by a significant reduction of 174 165 kcal that accounted for 13% of the initial REE.Conclusion: This study showed that inflammation is associated with increased REE in patients with CKD.
Keywords chronic kidney disease
resting energy expenditure
C-reactive protein
protein-energy malnutrition
Language English
Date 2005-10-01
Published in American Journal Of Clinical Nutrition. Bethesda: Amer Soc Clinical Nutrition, v. 82, n. 4, p. 801-805, 2005.
ISSN 0002-9165 (Sherpa/Romeo, impact factor)
Publisher Amer Soc Clinical Nutrition
Extent 801-805
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000232500600013

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