Resting energy expenditures in chronic kidney disease patients before, during, and after hemodialysis

Abstract

Background: Hemodialysis procedures of a long duration of 3–4 h may possibly affect resting energy expenditure (REE), leading to post-dialysis symptoms in chronic kidney disease (CKD). Objective: The purpose of this study was to continuously investigate REE before, during, and after hemodialysis in CKD patients. Method: Eleven hemodialysis patients voluntarily participated in this study. REE parameters, including oxygen consumption (VO₂), carbon dioxide production (VCO₂), and respiratory exchange ratio (RER), were continuously measured before, during, and after hemodialysis. Results: VO₂ after hemodialysis was higher than that before hemodialysis (244.92 ± 62.76 and 204.56 ± 38.94 ml/min at pre- and post-hemodialysis, respectively; P < 0.05). Additionally, RER at 30^th, 60^th, 150^th, 180^th, 210^th, and 240^th min during hemodialysis was higher than that after hemodialysis (0.92 ± 0.08, 0.93 ± 0.11, 0.92 ± 0.04, 0.90 ± 0.05, 0.90 ± 0.06, and 0.89 ± 0.05 and 0.81 ± 0.07 ml/min at 30^th, 60^th, 150^th, 180^th, 210^th, and 240^th min during and post-hemodialysis, respectively; P < 0.05), and REE was significantly different before and after hemodialysis (1463.40 ± 353.34 and 1664.54 ± 376.29 kcal/day at pre- and post-hemodialysis, respectively; P < 0.05). Moreover, REE at the 150^th, 210^th, and 240^th min of hemodialysis showed significant differences from REE after hemodialysis (1438.36 ± 370.31, 1493.18 ± 342.85 and 1548.14 ± 374.24 and 1664.54 ± 376.29 kcal/day at 150^th, 210^th, and 240^th min during and post-hemodialysis, respectively; P < 0.05). Conclusion: There were significantly changes in REE before, during, and after hemodialysis, and REE during hemodialysis was highest. VO₂ immediately increased after hemodialysis, and RER during hemodialysis was higher than that after hemodialysis, which indicated patients changed the sources of energy utilization from fat and carbohydrate to only carbohydrate. Therefore, ingredients of food intake should be considered before hemodialysis.