Skip to main content
SpringerLink
Log in

Basal metabolic rate in children with chronic kidney disease and healthy control children

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Background

Meeting energy requirements of children with chronic kidney disease (CKD) is paramount to optimising growth and clinical outcome, but little information on this subject has been published. In this study, we examined basal metabolic rate (BMR; a component of energy expenditure) with the aim to determine whether it is related to kidney function independently of weight, height and lean body mass (LBM).

Methods

Twenty children with CKD and 20 healthy age- and gender-matched control children were studied on one occasion. BMR was measured by indirect open circuit calorimetry and predicted by the Schofield equation. Estimated glomerular filtration rate (eGFR) was related to BMR and adjusted for weight, height, age and LBM measured by skinfold thickness.

Results

The adjusted BMR of children with CKD did not differ significantly from that of healthy subjects (1296 ± 318 vs.1325 ± 178 kcal/day; p = 0.720). Percentage of predicted BMR also did not differ between the two groups (102 ± 12 % vs. 99 ± 14 %; p = 0.570). Within the CKD group, eGFR (mean 33.7 ± 20.5 mL/min/m2) was significantly related to BMR (β 0.3, r = 0.517, p = 0.019) independently of nutritional status and LBM.

Conclusions

It seems reasonable to use estimated average requirement as the basis of energy prescriptions for children with CKD (mean CKD stage 3 disease). However, those who were sicker had significantly lower metabolic rates.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Scientific Advisory Committee on Nutrition (2011) Dietary reference values for energy. TSO, London. Available at: http://www.SACN.gov.uk

  2. Department of Health (1991) Dietary reference values for food energy and nutrients for the United Kingdom. No.41. HMSO, London

  3. Shaw V, Lawson M (2007) Clinical paediatric dietetics. Nutritional assessment. John Wiley & Sons, Chichester

  4. KDOQI Work Group (2009) KDOQI clinical practice guideline for nutrition in children with CKD: 2008 update. Executive summary. Am J Kidney Dis 53[3 Suppl 2]:S11-104

  5. Food and Agriculture Organization (2004) Human energy requirements. Report of a joint FAO/WHO/UNU Expert consultation no.1. FAO, Rome. Available at: http://www.fao.org

  6. Avesani CM, Draibe SA, Kamimura MA, Colugnati FA, Cuppari L (2004) Resting energy expenditure of chronic kidney disease patients: influence of renal function and subclinical inflammation. Am J Kidney Dis 44:1008–1016

    Article  PubMed  Google Scholar 

  7. Utaka S, Avesani CM, Draibe SA, Kamimura MA, Andreoni S, Cuppari L (2005) Inflammation is associated with increased energy expenditure in patients with chronic kidney disease. Am J Clin Nutr 82:801–805

    CAS  PubMed  Google Scholar 

  8. Kamimura MA, Draibe SA, Avesani CM, Canziani ME, Colugnati FA, Cuppari L (2007) Resting energy expenditure and its determinants in hemodialysis patients. Eur J Clin Nutr 61:362–367

    Article  CAS  PubMed  Google Scholar 

  9. Wang AY, Sea MM, Tang N, Lam CW, Chan IH, Lui SF, Sanderson JE, Woo J (2009) Energy intake and expenditure profile in chronic peritoneal dialysis patients complicated with circulatory congestion. Am J Clin Nutr 90:1179–1184

    Article  CAS  PubMed  Google Scholar 

  10. Mafra D, Deleaval P, Teta D, Cleaud C, Arkouche W, Jolivot A, Fouque D (2011) Influence of inflammation on total energy expenditure in hemodialysis patients. J Ren Nutr 21:387–393

    Article  PubMed  Google Scholar 

  11. Schneeweiss B, Graninger W, Stockenhuber F, Druml W, Ferenci P, Eichinger S, Grimm G, Laggner AN, Lenz K (1990) Energy metabolism in acute and chronic renal failure. Am J Clin Nutr 52:596–601

    CAS  PubMed  Google Scholar 

  12. Cuppari L, de Carvalho AB, Avesani CM, Kamimura MA, Dos Santos Lobao RR, Draibe SA (2004) Increased resting energy expenditure in hemodialysis patients with severe hyperparathyroidism. J Am Soc Nephrol 15:2933–2939

    Article  PubMed  Google Scholar 

  13. Marques de Aquino T, Avesani CM, Brasileiro RS, de Abreu Carvalhaes JT (2008) Resting energy expenditure of children and adolescents undergoing hemodialysis. J Ren Nutr 18:312–319

    Article  PubMed  Google Scholar 

  14. Tounian P, Salaun JF, Bensman A, Melchior JC, Veinberg F, Morgant G, Fontaine JL, Girardet JP (1995) Energy-balance in children and young-adults receiving hemodialysis for chronic renal failure. Clin Nutr 14:341–347

    Article  CAS  PubMed  Google Scholar 

  15. Shapiro AC, Bandini LG, Kurtin PS (1992) Estimating energy-requirements for children with renal-disease—a comparison of methods. J Am Diet Assoc 92:571–573

    CAS  PubMed  Google Scholar 

  16. IBM (2012) SPSS SamplePower. Available at: http://www.ibm.com/software/products/us/en/spss-samplepower

  17. SECA GmbH & Co. KG (2012). Available at: http://www.seca.com/english/uk/home/. Accessed 23 Sept 2013

  18. Child Growth Foundation (1994) LMS growth programme. Harlow Healthcare, South Shields. Available at: http://www.childgrowthfoundation.org. Accessed Jan 2007

  19. Delderfield M (2005) SDS individual calculator for British 1990 Growth Reference Data. Public Health Informatics, University of Manchester, Manchester. Available at: http://www.phsim.man.ac.uk/SDScalculator. Accessed Dec 2014

  20. Baty International. Available at: http://www.baty.co.uk/products/categories/170. Accessed Jan 2007

  21. Lohman TG, Slaughter MH, Boileau RA, Bunt J, Lussier L (1984) Bone mineral measurements and their relation to body density in children, youth and adults. Hum Biol 56:667–679

    CAS  PubMed  Google Scholar 

  22. GE Healthcare. Deltatrac 11. GH Healthcare UK, Little Chalfont. Available at: http://www.gehealthcare.com/usen/oximetry/docs/881439.pdf. Accessed 23 Sept 2013

  23. Garrow JS, James WPT, Ralph A (2000) Human nutrition and dietetics, 10th edn. Churchill Livingston, Edinburgh

    Google Scholar 

  24. Medical Research Council. Physical activity assessment—indirect calorimetry. Available at http://dapa-toolkit.mrc.ac.uk/physical-activity-assessment/methods/indirect-calorimetry/index.html. Accessed 31 March 2011

  25. University Hospital Southampton Southampton University Hospital NHS Foundation Trust UHS SUHNFT (2006/2007) Standard operating procedure: measuring resting energy expenditure using indirect calorimetry: GEM standard operating procedure: measuring resting energy expenditure using indirect calorimetry: GEM). Standard operating procedure. WTCRF, Southampton University Hospital NHS Foundation Trust, Southampton

  26. UHS SUHNFT (2006/2007) Standard operating procedure: measuring resting energy expenditure using indirect calorimetry: Delta-trac II standard operating procedure: measuring resting energy expenditure using indirect calorimetry: Delta-trac II). Standard operating procedure. WTCRF, Southampton University Hospital NHS Foundation Trust, Southampton

  27. Elia M, Livesey G (1992) Energy expenditure and fuel selection in biological systems: the theory and practice of calculations based on indirect calorimetry and tracer methods. World Rev Nutr Diet 70:68–131

    Article  CAS  PubMed  Google Scholar 

  28. Schofield WN (1985) Predicting basal metabolic rate, new standards and review of previous work. Hum Nutr Clin Nutr 39[Suppl 1]:5–41

    PubMed  Google Scholar 

  29. Schwartz GJ, Haycock GB, Edelmann CM Jr, Spitzer A (1976) A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics 58:259–263

    CAS  PubMed  Google Scholar 

  30. IBM SPSS (2012) Available at: http://public.dhe.ibm.com/common/ssi/ecm/en/yts03009usen/YTS03009USEN.PDF. Accessed 23 Sept 2013

  31. Kuhlmann U, Schwickardi M, Trebst R, Lange H (2001) Resting metabolic rate in chronic renal failure. J Ren Nutr 11:202–206

    Article  CAS  PubMed  Google Scholar 

  32. Panesar A, Agarwal R (2003) Resting energy expenditure in chronic kidney disease: relationship with glomerular filtration rate. Clin Nephrol 59:360–366

    Article  CAS  PubMed  Google Scholar 

  33. Elia M (1992) Energy expenditure in the whole body. Energy metabolism. Tissue determinants and cellular corollaries. Raven Press, New York

    Google Scholar 

  34. Wang AY-M, Sea MM-M, Tang N, Lam CW-K, Chan IH-S, Lui S-F, Sanderson JE, Woo J (2009) Energy intake and expenditure profile in chronic peritoneal dialysis patients complicated with circulatory congestion. Am J Clin Nutr 90:1179–1184

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

Research funding was awarded by the Health Foundation, through the ‘Leadership through clinical practice award’ (2005), for clinical research and leadership training. This study was also supported by the NIHR Southampton Clinical Research Facility.

This report is independent research by the National Institute for Health Research Biomedical Research Unit Funding Scheme. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

Author information

Authors and Affiliations

  1. Department of Nutrition and Dietetics, NIHR Southampton Biomedical Research Centre–Nutrition, Southampton Children’s Hospital, University of Southampton–University Hospital Southampton NHS Foundation Trust, E level Tremona Road, Southampton, SO16 6YD, UK

    Caroline E. Anderson

  2. Southampton Children’s Hospital, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK

    Rodney D. Gilbert

  3. NIHR Southampton Biomedical Research Centre–Nutrition, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK

    Marinos Elia

Authors
  1. Caroline E. Anderson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rodney D. Gilbert
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marinos Elia
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Caroline E. Anderson.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Anderson, C.E., Gilbert, R.D. & Elia, M. Basal metabolic rate in children with chronic kidney disease and healthy control children. Pediatr Nephrol 30, 1995–2001 (2015). https://doi.org/10.1007/s00467-015-3095-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-015-3095-5

Keywords

Search

Navigation