Energy Expenditure Dynamics in Chronic Kidney Disease

Energy expenditure in chronic kidney disease (CKD) reflects a delicate balance between basal metabolic demands, effects of renal dysfunction and the extra physiological load imposed by dialysis or conservative treatment. Patients with CKD often exhibit altered resting energy expenditure (REE) and total energy expenditure due to inflammation, metabolic acidosis, hormonal imbalances and loss of lean body mass. Protein-energy wasting is a frequent complication, driven by heightened catabolism and reduced physical activity, which together undermine nutritional status and exacerbate morbidity. Dialysis modalities further influence patterns of substrate use and day-night fluctuations in energy turnover. Accurate assessment of energy requirements is critical to tailor nutritional interventions, mitigate muscle loss and improve clinical outcomes. Traditional predictive equations frequently misestimate needs, particularly at extremes of body mass index or in the presence of comorbidities. Advances in genetic epidemiology, machine learning and refined calorimetric techniques are reshaping our understanding of how disease-specific factors and treatment modalities modulate energy expenditure throughout the spectrum of CKD.

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Energy Expenditure Dynamics in Chronic Kidney Disease publication trend

The graph below shows the total number of articles in energy expenditure dynamics in chronic kidney disease across all publications each year (not limited to Nature Index journals).

Technical terms

Basal metabolic rate: The minimal rate of energy expenditure measured under strict resting conditions.

Resting energy expenditure (REE): The energy expended by an individual at rest over a defined period, incorporating basic metabolic functions.

Indirect calorimetry: A method that estimates energy expenditure by measuring oxygen consumption and carbon dioxide production.

Mendelian randomisation: An analytical approach using genetic variants as instrumental variables to infer causal relationships between exposures and outcomes.

Protein-energy wasting (PEW): A state of decreased body protein and fat mass common in CKD, driven by heightened catabolism and reduced intake.

References

1. Causal relationship between basal metabolic rate and kidney function: a bidirectional two-sample mendelian randomization study. Frontiers in Endocrinology (2024).
2. Machine learning models using non-linear techniques improve the prediction of resting energy expenditure in individuals receiving hemodialysis. Annals of Medicine (2023).
3. Agreement Between Resting Energy Expenditure Predictive Formulas and Indirect Calorimetry in Non-Dialysis Dependent Chronic Kidney Disease. Diagnostics (2024).
4. Day and night changes in energy expenditure of patients on automated peritoneal dialysis. Clinical Nutrition (2020).