The Impact of Protein Intake on Renal Function Decline in Women with Normal Renal Function or Mild Renal Insufficiency

Knight, Eric L.; Stampfer, Meir J.; Hankinson, Susan E.; Spiegelman, Donna; Curhan, Gary C.

doi:10.7326/0003-4819-138-6-200303180-00009

Cited by 363 publications

(271 citation statements)

References 39 publications

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“…It is also possible that lower animal protein and red meat intake characteristic of this type of diet may benefit kidney function (39,40). Although meat consumption was not associated with incident eGFR,60 ml/min per 1.73 m 2 , this study may have been inadequately powered to detect a relationship.…”

Section: Discussionmentioning

confidence: 44%

The Association between a Mediterranean-Style Diet and Kidney Function in the Northern Manhattan Study Cohort

Khatri¹,

Moon

Scarmeas

et al. 2014

Clinical Journal of the American Society of Nephrology

113

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Background and objectives Various dietary strategies have been investigated to slow kidney function decline. However, it is unknown whether a Mediterranean diet, which has been associated with improved cardiovascular risk, is associated with change in kidney function.Design, setting, participants, & measurements This study used the Northern Manhattan Study, a prospective, multiethnic, observational cohort of participants who were stroke free at baseline. Data were collected between 1993 and 2008. Serum creatinine measurements were taken a mean 6.9 years apart. A baseline dietary questionnaire was extrapolated into a previously used 9-point scoring system (MeDi). The primary outcome was incident eGFR,60 ml/min per 1.73 m 2 using the Modification of Diet in Renal Disease formula. A secondary outcome was the upper quartile of annualized eGFR decline ($2.5 ml/min per 1.73 m 2 per year). Conditional logistic regression models adjusted for demographics and baseline vascular risk factors.Results Mean baseline age was 64 years, with 59% women and 65% Hispanics (N=900); mean baseline eGFR was 83.1 ml/min per 1.73 m 2 . Incident eGFR,60 ml/min per 1.73 m 2 developed in 14% . In adjusted models, every 1-point increase in the MeDi score, indicating increasing adherence to a Mediterranean diet, was associated with decreased odds of incident eGFR,60 ml/min per 1.73 m 2 (odds ratio, 0.83; 95% confidence interval, 0.71 to 0.96) and decreased odds of being in the upper quartile of eGFR decline (odds ratio, 0.88; 95% confidence interval, 0.79 to 0.98).Conclusions A Mediterranean diet was associated with a reduced incidence of eGFR,60 ml/min per 1.73 m 2 and upper quartile of eGFR decline in a multiethnic cohort.

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Section: Discussionmentioning

confidence: 44%

The Association between a Mediterranean-Style Diet and Kidney Function in the Northern Manhattan Study Cohort

Khatri¹,

Moon

Scarmeas

et al. 2014

Clinical Journal of the American Society of Nephrology

113

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“…This could be explained by reduced adherence to the study diets, although persistent differences in serum urea levels even at 24 months argue against this possibility. Alternative explanations are that hyperfiltration-related kidney damage is not induced in individuals with normal baseline function regardless of their weight (40) or that more than 2 years or more sensitive markers are needed to detect any detrimental effects. Although we do not believe that the drop in creatinine clearance between 12 and 24 months reflects hyperfiltration-related Estimated using a linear mixed-effects model.…”

Section: Discussionmentioning

confidence: 99%

Comparative Effects of Low-Carbohydrate High-Protein Versus Low-Fat Diets on the Kidney

Friedman

Ogden

Foster

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Concerns exist about deleterious renal effects of low-carbohydrate high-protein weight loss diets. This issue was addressed in a secondary analysis of a parallel randomized, controlled long-term trial.Design, setting, participants, and measurements Between 2003 and 2007, 307 obese adults without serious medical illnesses at three United States academic centers were randomly assigned to a low-carbohydrate highprotein or a low-fat weight-loss diet for 24 months. Main outcomes included renal filtration (GFR) indices (serum creatinine, cystatin C, creatinine clearance); 24-hour urinary volume; albumin; calcium excretion; and serum solutes at 3, 12, and 24 months.Results Compared with the low-fat diet, low-carbohydrate high-protein consumption was associated with minor reductions in serum creatinine (relative difference, 24.2%) and cystatin C (28.4%) at 3 months and relative increases in creatinine clearance at 3 (15.8 ml/min) and 12 (20.8 ml/min) months; serum urea at 3 (14.4%), 12 (9.0%), and 24 (8.2%) months; and 24-hour urinary volume at 12 (438 ml) and 24 (268 ml) months. Urinary calcium excretion increased at 3 (36.1%) and 12 (35.7%) months without changes in bone density or clinical presentations of new kidney stones.Conclusions In healthy obese individuals, a low-carbohydrate high-protein weight-loss diet over 2 years was not associated with noticeably harmful effects on GFR, albuminuria, or fluid and electrolyte balance compared with a low-fat diet. Further follow-up is needed to determine even longer-term effects on kidney function.

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“…In adults, high protein intake is known to induce renal hypertrophy and glomerular sclerosis through a SNGHF, especially when the nephron number is reduced (17)(18)(19). In young animals, especially in IUGR rat offspring, we and others have shown that early postnatal overnutrition induced obesity, cardiovascular, metabolic, and renal diseases at adulthood (13)(14)(15).…”

mentioning

confidence: 99%

High protein intake in neonatal period induces glomerular hypertrophy and sclerosis in adulthood in rats born with IUGR

et al. 2015

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Background: Intrauterine growth restriction (IUGR) and postnatal nutrition are risk factors for cardiovascular and renal diseases in both humans and animals. The long-term renal effects of protein intake early in life remain unknown. The objective was to evaluate the effects of a neonatal feeding with high protein (HP) milk on renal functions and structure in IUGR male rats. Methods: Maternal gestational low protein diet was used to produce IUGR. At day 5, IUGR pups were gastrostomized in the "pup-in-the cup" model and received either normal protein (NP) milk or HP (+50% protein content) milk until day 21. After weaning, the animals were fed the same standard diet. Renal functions and structure were assessed at postnatal day 18 (D18) and in adult offspring. results: During the preweaning period, the postnatal weight gain between the two groups was unaffected. On D18, kidneys from HP offspring were heavier with significant glomerular hypertrophy (+40%, P < 0.05). HP diet was associated with significant proteinuria and glomerulosclerosis (+49%, P < 0.05). Glomerular number was unaltered. conclusion: Neonatal HP feeding following IUGR affects renal functions and structure at adulthood. These alterations may result from a single nephron glomerular hyperfiltration.

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The Impact of Protein Intake on Renal Function Decline in Women with Normal Renal Function or Mild Renal Insufficiency

Cited by 363 publications

References 39 publications

The Association between a Mediterranean-Style Diet and Kidney Function in the Northern Manhattan Study Cohort

The Association between a Mediterranean-Style Diet and Kidney Function in the Northern Manhattan Study Cohort

Comparative Effects of Low-Carbohydrate High-Protein Versus Low-Fat Diets on the Kidney

High protein intake in neonatal period induces glomerular hypertrophy and sclerosis in adulthood in rats born with IUGR

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