Poor Agreement between Predictive Equations of Energy Expenditure and Measured Energy Expenditure in Critically Ill Acute Kidney Injury Patients.

Background: There are multiple equations for predicting resting energy expenditure (REE), but how accurate they are in severe acute kidney injury (AKI) patients is not clear. Our aim was to determine if predictive equations for estimated REE accurately reflect the requirements of AKI patients.

Methods: We included in this prospective and observational study AKI patients AKIN-3 assessed by indirect calorimetry (IC).

Aldosterone is associated with left ventricular hypertrophy in hemodialysis patients.

Objectives: Patients with chronic kidney disease present a higher degree of left ventricular hypertrophy than expected for hypertension levels. In chronic kidney disease the plot between the quotient extracellular water/total body water and aldosterone is shifted up and to the right. There are few studies that verified the role of aldosterone in cardiac remodeling in this set of patients.

Spironolactone is secure and reduces left ventricular hypertrophy in hemodialysis patients.

Objectives: There is recent evidence that aldosterone play a role in the pathogenesis of cardiovascular disease in dialysis patients, which leads to the opportunity to block its actions for the benefit of these patients. In nondialytic chronic kidney disease, spironolactone was safe and effective in reducing left ventricular hypertrophy. However, routine use has been precluded in hemodialysis patients due to the risk of hyperkalemia.