POS-726 NOVEL EQUATIONS FOR ESTIMATING RESTING ENERGY EXPENDITURE IN PERITONEAL DIALYSIS PATIENTS

Abstract

With the development of chronic kidney disease (CKD), the risk of protein-energy wasting is increasing. It is urgent to have a convenient method to assess energy expenditure accurately in these patients. However, besides the direct measurement, which is expensive and time-consuming, there is no resting energy expenditure (REE) equations focus on peritoneal dialysis patients. We aimed to develop and validate REE equations in peritoneal dialysis patients. This cross-sectional study enrolled 140 patients with peritoneal dialysis according to inclusion and exclusion criteria. After random sampling matched 1:1 by age, gender and dialysis duration, stepwise linear regression analysis was used to derive a new REE equation (eREEpd) according to actual REE (aREE) measured using indirect calorimetry in the development dataset. The eREEpd value was then validated with aREE in the validation dataset in terms of bias, precision, and accuracy. Bias was assessed as the difference between the estimated and measured REE values, precision was assessed as the absolute value of difference, and accuracy was assessed as the percentage of estimates that differed >20% from the measured REE (1- P20). The eREEpd equation: eREEpd (kcal) = (1 if male; 0 if female) × 144.08 − 5.8 × age (y) + 10.33 × weight (kg)+ 850.71 (R2 = 0.649). The bias, precision, and accuracy of the eREEpd equation were -11.3 (IQR: −195.7, 115.0) kcal, 22.2 (IQR:64.9, 249.3) kcal, and 20.3%, respectively with indirect calorimetry as the reference method. Besides, we found hemoglobin was an independent predictive factor of REE developed an REE equation using age, sex, weight, and hemoglobin data, as eREEpd_Hb (kcal) = (1 if male; 0 if female) × 172.16 − 4.87 × age (y) + 9.63 × weight (kg)-3.05×hemoglobin (g/L)+ 1180.04 (R2 = 0.673).The bias, precision, and accuracy (percentage of estimates that differed >20% from the measured REE) of the eREEpd_Hb equation were 31.5 (IQR: −174.3, 102.0) kcal, 120.8 (IQR:59.6, 239.2) kcal, and 18.6%, respectively with indirect calorimetry as the reference method. The REE equation using age, sex, weight with or without hemoglobin data could serve as a reliable tool for estimating REE in patients with peritoneal dialysis.