Energy expenditure and inflammation in CKD
Research type
Research Study
Full title
Measures of inflammation, activity-related and total energy expenditure in chronic kidney disease
IRAS ID
139951
Contact name
Jonathan P Wong
Contact email
Sponsor organisation
East and North Hertfordshire NHS Trust
Research summary
Study synopsis\n\nInflammation and protein energy malnutrition is common in patients with chronic kidney disease (CKD). The presence of malnutrition-inflammation syndrome is associated with future adverse outcomes and the prevalence increases as patients with end stage kidney failure embark on renal replacement therapy. Early nutritional intervention would be important to ameliorate this effect. There are reports that patients with CKD have different levels of energy expenditure compared to the normal population. Measurement of a patient’s energy expenditure would be useful to guide nutritional management. Current methods of measuring energy expenditure are cumbersome and difficult to use in clinical practice. Physical activity questionnaires have been validated to measure physical activity related energy expenditure in healthy individuals but not in patients with CKD. \n\nAim\n\nWe aim to study how energy expenditure differs in patients of different body composition and inflammatory state with various levels of CKD and validate the use of physical activity questionnaires to calculate energy expenditure in CKD.\n\nMethod \n\nPatients will be recruited from the nephrology clinics at East and North Hertfordshire NHS Trust. Inflammatory status will be measured using blood serum analysis for highly sensitive CRP. We will measure resting energy expenditure using indirect calorimeter. Patients will be asked to lie under an overhead canopy and expired gases will be collected for analysis. Physical activity will be measured using an accelerometer device, participants will be requested to wear this device on the wrist for a week whilst performing routine daily activities. Total energy expenditure will be measured using doubly-labelled water technique. This involves the oral administration of stable isotope labelled deuterium oxide and oxygen-18 water to participants. Body composition will be measured using bio-impedance device. Physical activity data will be collected using questionnaires and the information will be validated against data obtained from indirect calorimetry, accelerometer device and doubly-labelled water technique.\n
REC name
East of England - Cambridgeshire and Hertfordshire Research Ethics Committee
REC reference
13/EE/0388
Date of REC Opinion
27 Nov 2013
REC opinion
Favourable Opinion