Evaluation of Factors Associated with Hypermetabolism and Hypometabolism in Critically Ill AKI Patients
Acute kidney injury (AKI) is a frequent and serious condition with high mortality. The presence of hypermetabolism may be a factor related to poorer prognosis. This study evaluated the resting energy expenditure (REE) of intensive care unit (ICU) patients with severe AKI using indirect calorimetry (...
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| Format: | Article |
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MDPI AG
2018-04-01
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| Series: | Nutrients |
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| Online Access: | http://www.mdpi.com/2072-6643/10/4/505 |
| _version_ | 1811314791615037440 |
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| author | Cassiana R. de Góes André Luis Balbi Daniela Ponce |
| author_facet | Cassiana R. de Góes André Luis Balbi Daniela Ponce |
| author_sort | Cassiana R. de Góes |
| collection | DOAJ |
| description | Acute kidney injury (AKI) is a frequent and serious condition with high mortality. The presence of hypermetabolism may be a factor related to poorer prognosis. This study evaluated the resting energy expenditure (REE) of intensive care unit (ICU) patients with severe AKI using indirect calorimetry (IC) and identified factors associated with metabolism categories. Patients were evaluated through measurement of REE and estimation of basal energy expenditure (BEE) using the Harris–Benedict equation. Metabolism categories were as follows: hypermetabolism (REE/BEE > 1.3) and hypometabolism (REE/BEE < 0.9). The metabolism categories were compared using ANOVA and the chi-square test. Variables were analyzed by multiple logistic regression tests. Also, survivors and non-survivors were compared using Student’s t-tests along with Cox regression tests. Kaplan–Meier survival curves were also performed. We evaluated 124 patients with a mean age of 61.08 ± 16.6 years. Sixty-four patients were hypermetabolic (62%) and 18 were hypometabolic (14%). Vasoactive drug (VAD) dose and younger age were independently associated with hypermetabolism. The survival analysis was not associated with metabolism categorization. In conclusion, patients with severe AKI are mostly hypermetabolic and hypermetabolic patients of a lower age receiving treatment with higher VAD doses. The only factors associated with death were protein intake and VAD dose. |
| first_indexed | 2024-04-13T11:18:38Z |
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| id | doaj.art-4385654f4e8841e59b3d1c4b92faf3be |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-04-13T11:18:38Z |
| publishDate | 2018-04-01 |
| publisher | MDPI AG |
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| series | Nutrients |
| spelling | doaj.art-4385654f4e8841e59b3d1c4b92faf3be2022-12-22T02:48:54ZengMDPI AGNutrients2072-66432018-04-0110450510.3390/nu10040505nu10040505Evaluation of Factors Associated with Hypermetabolism and Hypometabolism in Critically Ill AKI PatientsCassiana R. de Góes0André Luis Balbi1Daniela Ponce2Internal Medicine Department, Faculdade de Medicina de Botucatu, São Paulo State University “UNESP—Univ Estadual Paulista”, Paranapanema Avenue, 165, Avaré, São Paulo 18701240, BrazilInternal Medicine Department, Faculdade de Medicina de Botucatu, São Paulo State University “UNESP—Univ Estadual Paulista”, Paranapanema Avenue, 165, Avaré, São Paulo 18701240, BrazilInternal Medicine Department, Faculdade de Medicina de Botucatu, São Paulo State University “UNESP—Univ Estadual Paulista”, Paranapanema Avenue, 165, Avaré, São Paulo 18701240, BrazilAcute kidney injury (AKI) is a frequent and serious condition with high mortality. The presence of hypermetabolism may be a factor related to poorer prognosis. This study evaluated the resting energy expenditure (REE) of intensive care unit (ICU) patients with severe AKI using indirect calorimetry (IC) and identified factors associated with metabolism categories. Patients were evaluated through measurement of REE and estimation of basal energy expenditure (BEE) using the Harris–Benedict equation. Metabolism categories were as follows: hypermetabolism (REE/BEE > 1.3) and hypometabolism (REE/BEE < 0.9). The metabolism categories were compared using ANOVA and the chi-square test. Variables were analyzed by multiple logistic regression tests. Also, survivors and non-survivors were compared using Student’s t-tests along with Cox regression tests. Kaplan–Meier survival curves were also performed. We evaluated 124 patients with a mean age of 61.08 ± 16.6 years. Sixty-four patients were hypermetabolic (62%) and 18 were hypometabolic (14%). Vasoactive drug (VAD) dose and younger age were independently associated with hypermetabolism. The survival analysis was not associated with metabolism categorization. In conclusion, patients with severe AKI are mostly hypermetabolic and hypermetabolic patients of a lower age receiving treatment with higher VAD doses. The only factors associated with death were protein intake and VAD dose.http://www.mdpi.com/2072-6643/10/4/505acute kidney injuryenergy metabolismdialysiscritical care |
| spellingShingle | Cassiana R. de Góes André Luis Balbi Daniela Ponce Evaluation of Factors Associated with Hypermetabolism and Hypometabolism in Critically Ill AKI Patients Nutrients acute kidney injury energy metabolism dialysis critical care |
| title | Evaluation of Factors Associated with Hypermetabolism and Hypometabolism in Critically Ill AKI Patients |
| title_full | Evaluation of Factors Associated with Hypermetabolism and Hypometabolism in Critically Ill AKI Patients |
| title_fullStr | Evaluation of Factors Associated with Hypermetabolism and Hypometabolism in Critically Ill AKI Patients |
| title_full_unstemmed | Evaluation of Factors Associated with Hypermetabolism and Hypometabolism in Critically Ill AKI Patients |
| title_short | Evaluation of Factors Associated with Hypermetabolism and Hypometabolism in Critically Ill AKI Patients |
| title_sort | evaluation of factors associated with hypermetabolism and hypometabolism in critically ill aki patients |
| topic | acute kidney injury energy metabolism dialysis critical care |
| url | http://www.mdpi.com/2072-6643/10/4/505 |
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