Mechanisms permitting nephrotic patients to achieve nitrogen equilibrium with a protein-restricted diet.

Maroni, Bradley J.; Staffeld, C.; Young, Vernon R.; Manatunga, Amita K.; Tom, Karen

doi:10.1172/jci119432

Cited by 77 publications

(41 citation statements)

References 40 publications

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“…If there has been loss of muscle mass but no reason that protein breakdown is accelerated by other illnesses, then 0.8 g/kg per d of dietary protein will be sufficient (20). With proteinuria, the diet should contain no more than 0.8 g of protein/kg per d plus 1 g of protein per gram of proteinuria; even less dietary protein may be sufficient (20,22).…”

mentioning

confidence: 99%

Diets For Patients With Chronic Kidney Disease, Still Worth Prescribing

Mitch,

Remuzzi

2004

Journal of the American Society of Nephrology

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mentioning

confidence: 99%

Diets For Patients With Chronic Kidney Disease, Still Worth Prescribing

Mitch,

Remuzzi

2004

Journal of the American Society of Nephrology

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“…Intestinal edema developing secondary to massive proteinuria-associated hypoalbuminemia reduces nutrient absorption and leads to malnutrition and activation of inflammatory cascade. Various inflammatory mediators (such as TNF α) exhibit a negative inotropic effect on the myocardium (5,18,19). In this way, malnutrition and inflammation lead to an increase in cardiovascular events incidence in the NS patient group.…”

Section: Discussionmentioning

confidence: 99%

“…Proteinuria in NS patients causes inflammatory cytokine release during endothelial injury, tubular reabsorption and tubular catabolism (23,24). In addition, malnutrition developing secondary to hypoalbuminemia leads to inflammatory cascade activation and cytokine release (5,18,19). Studies have shown that inflammatory cytokines cause myocardial injury (5).…”

Section: Discussionmentioning

confidence: 99%

Presence of fragmented QRS and its correlation with myocardial performance index in patients with nephrotic syndrome

Özkan

Adar²,

Ulusoy³

et al. 2014

Anadolu Kardiyol Derg

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Objective: More cardiovascular events are seen in nephrotic syndrome (NS) patients than in the normal population. Fragmented QRS (fQRS) includes various RSR' patterns with different morphologies of the QRS complexes with or without the Q wave on a resting 12-lead ECG. A relationship between the presence of fQRS and myocardial function impairment has been shown in several studies. The purpose of this study was to evaluate the presence of fQRS in this patient group and the relationship with myocardial functions. Methods: Thirty-four NS patients were included in the cross-sectional study. Demographic data were recorded, and electrocardiograms (ECGs) were analyzed for the presence of fQRS following investigation of biochemical parameters and 24-h protein excretion. In addition to classic echocardiographic parameters, the myocardial performance (Tei index) was calculated as an indicator of cardiac function. For comparison of group's data Student's t-test and Mann-Whitney U test were used. Multiple linear regression analysis was performed for parameters affecting presence of fQRS. Results: We identified fQRS in half of our patients group. Patients with fQRS had significantly greater proteinuria level and Tei index than those without (p<0.05 and p<0.001, respectively). Tei index was also affected presence of fQRS (p<0.05, β=0.45, R 2 =0.32) and positively correlated with proteinuria levels (p<0.05 r=0.366). Conclusion: We demonstrated, for the first time in the literature, that the determination of fQRS in patients with NS in surface ECG, an easily accessible technique, can be used as a parameter in the prediction of myocardial functions. (Anadolu Kardiyol Derg 2014; 14: 450-5)

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“…Penelitian Maroni BJ dkk 16 terhadap 5 pasien sindrom nefrotik dewasa yang mendapatkan diet rendah protein dan tinggi protein ternyata didapatkan keseimbangan nitrogen yang positif baik pada kelompok rendah maupun tinggi protein. Pada penelitian ini protein diberikan mulai dari 1,5 g/kgBB/ hari dan terbukti meningkatkan kadar protein dan albumin serum.…”

Section: Pembahasanunclassified

“…[19][20] Salah satu pengukuran untuk menilai penggunaan protein diet adalah dengan keseimbangan nitrogen. [15][16] Penelitian untuk mengetahui kinerja protein dari diet dengan menggunakan teknik N labeled protein didapatkan bahwa nitrogen diet lebih berperan pada jalur anabolisme yaitu sintesis protein. 21 Patogenesis sintesis protein pada sindrom nefrotik adalah multifaktorial dan dipengaruhi juga oleh kadar proteinuria.…”

Section: Pembahasanunclassified

Pemberian Diet Formula Tepung Ikan Gabus (Ophiocephalus striatus) pada Sindrom Nefrotik

Kusumawardhani

Mexitalia

Susanto

et al. 2016

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Latar belakang. Pemberian diet dengan protein seimbang pada sindrom nefrotikbertujuan untuk meningkatkan kadar albumin serum. Ikan gabus merupakan ikan airtawar yang banyak dijumpai di Indonesia dan memiliki kadar protein lebih tinggidibandingkan ikan lainnya.Tujuan Penelitian. Penelitian ini bertujuan untuk mengevaluasi pemberiansuplementasi formula tepung ikan gabus terhadap peningkatan kadar albumin serumpasien sindrom nefrotik.Metodologi. Penelitian uji klinik terbuka dilakukan di Bangsal Anak RS Dr. KariadiSemarang, pada 36 anak dengan sindrom nefrotik kelainan minimal, yang terbagi dalamkelompok perlakuan dan kelompok kontrol. Kelompok perlakuan mendapatkansuplementasi ikan gabus, dengan cara mengganti 25% kebutuhan protein dengan tepungikan gabus. Suplemntasi ikan gabus diberikan setiap hari selama 21 hari, dengan jumlahprotein total yang diberikan sama dengan kelompok kontrol. Indeks masa tubuh (IMT),protein total, albumin dan globulin serum diukur setiap minggu, sedangkan akseptabilitastepung ikan gabus dinilai setiap hari. Analisis statistik menggunakan uji t independent.Hasil. Pada kedua kelompok didapatkan peningkatan IMT, kadar protein total danalbumin serum pada akhir penelitian dibandingkan dengan data awal. Tidak didapatkanperbedaan kadar protein total dan globulin pada akhir penelitian antara kelompokperlakuan dan kelompok kontrol. Selisih kenaikan kadar albumin pada kelompokperlakuan (2,04 ± 1,47 g/dl) lebih tinggi secara bermakna dibandingkan dengan kelompokperlakuan (1,47 ± 0,82 g/dl) dengan nilai p = 0,018.Kesimpulan. Pemberian suplementasi tepung ikan gabus selama 21 hari pada pasiensindrom nefrotik kelainan minimal dapat meningkatkan kadar albumin serum.

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Mechanisms permitting nephrotic patients to achieve nitrogen equilibrium with a protein-restricted diet.

Abstract: Clinical experience suggests nephrotic patients are at risk for malnutrition. To determine if nephrotic patients can adapt successfully to a protein-restricted diet, nephrotic (glomerular filtration rate, 52 Ϯ 15 ml/min; urinary protein

Cited by 77 publications

References 40 publications

Diets For Patients With Chronic Kidney Disease, Still Worth Prescribing

Diets For Patients With Chronic Kidney Disease, Still Worth Prescribing

Presence of fragmented QRS and its correlation with myocardial performance index in patients with nephrotic syndrome

Pemberian Diet Formula Tepung Ikan Gabus (Ophiocephalus striatus) pada Sindrom Nefrotik

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