Reliable Noninvasive Methods for Assessing Nutritional Status and Basal energy Expenditure in Maintenance Hemodialysis Patients: Focus on Basal Energy Expenditure

Abstract

Our aim was to (1) evaluate the agreement between basal energy Expenditure (BEE) derived from bioelectrical impedance analysis (BIA) immediately after hemodialysis (HD) and BEE determined using the Harris–Benedict equation and (2) identify the determinants of BEE in patients receiving HD. This cross-sectional study included 35 patients treated with HD two to three times a week from 2003 to 2004 at Taipei Municipal Zhongxiao Hospital. BEE was measured using BIA immediately after HD. Next, Altman–Bland analysis of BEE was performed to evaluate the agreement between the BIA method and the Harris–Benedict method. Correlation and multiple linear regression analyses were performed to examine the association of BEE with demographic data, anthropometric data, and body composition. BEE derived from BIA immediately after HD exhibited poor agreement with BEE determined using the Harris–Benedict method and was nonsignificantly larger. BEE was also positively correlated with lean body mass. In the multiple linear regression analysis, lean body mass was the most powerful independent determinant of BIA-derived BEE. Gender-based differences, height and lean body mass were noted in the prediction of BIA-derived BEE. This study revealed that understanding of the changes of scheduled basal energy Expenditure is paramount and related to changes of lean body mass condition of maintenance hemodialysis patients.