Arkouche W, Fouque D, Pacchiaudi C, Normand S, et al.
Resting metabolic rate in patients undergoing CAPD
Am Soc Nephrol
J Am Soc Nephrol (abstract) (Sep) 7:1506 1996

Energy intake has been relatively neglected, as compared to protein intake, in PD patients. Arkouche et al measure resting metabolic rate by indirect calorimetry in 10 maintenance CAPD patients with a mean age of 69. Measurements were made after an overnight fast and at complete physical rest. They were compared with those calculated from the Harris- Benedict formula. They found almost no difference between the values from indirect calorimetry and the formula. These were 1232 and 1291 kcals, respectively. They conclude that the Harris- Benedict method is a reasonably accurate estimate of resting metabolic rate and therefore can be helpful in defining patient's daily energy requirements.

Comment: This is an important validation of the Harris-Benedict equation in PD patients. The findings, at first sight surprising, are consistent with recent work by Harty et al which showed similar values of resting metabolic rate in 12 CAPD patients and no difference from normal controls. The relatively high respiratory quotient of .88 after an overnight fast detected in this study is consistent with glucose absorption from the dialysate providing substrate for oxidation, and is similar to that found in Harty's study. Long-term studies describing energy intake in PD patients and relating it to outcome are required. (Peter G. Blake, M.D., Victoria Hospital, London, Ontario)

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Am Soc Nephrol
CRF by organ system : Nutrition