University of Hertfordshire

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Comparison of energy estimates in chronic kidney disease using doubly-labelled water

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Original languageEnglish
Pages (from-to)59-66
Number of pages8
JournalJournal of human nutrition and dietetics : the official journal of the British Dietetic Association
Early online date15 Jul 2015
Publication statusPublished - 27 Jan 2016


BACKGROUND: Total energy expenditure (TEE) is estimated in clinical practice as a combined measure of resting energy expenditure and physical activity level. Commonly available questionnaires to estimate physical activity level have not been validated in patients with kidney disease using the doubly-labelled water method.

METHODS: This prospective, cross-sectional study was conducted on 40 patients with chronic kidney disease stages 1-5 with the objective of validating two physical activity questionnaires: the Recent Physical Activity Questionnaire (RPAQ) and the Stanford 7-day recall questionnaire. TEE was measured using doubly-labelled water technique. TEE was also estimated using predicted resting energy expenditure and estimated physical activity measures from the questionnaires.

RESULTS: Measured TEE correlated better with TEE estimated from RPAQ compared to that from the Stanford questionnaire. In Bland-Altman analysis, TEE estimated from RPAQ had the least bias and narrower limits of agreement compared to the measured TEE. A metabolic equivalent of task value of 1.3 for the unaccounted time in RPAQ provided the best approximation of estimated TEE to the measured TEE.

CONCLUSIONS: RPAQ is an acceptable questionnaire tool for assessing physical activity level in patients with chronic kidney disease.


This is the peer reviewed version of the following article: S. Sridharan, J. Wong, E. Vilar, and K. Farrington, ‘Comparison of energy estimates in chronic kidney disease using doubly-labelled water’, Journal of Human Nutrition and Dietetics, Vol. 29 (1): 59-66, February 2016, which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. © 2015 The British Dietetic Association Ltd.

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