Dietary Protein Intake and Renal Function

2013 ◽  
pp. 121-140
Author(s):  
William Martin ◽  
Lawrence Armstrong ◽  
Nancy Rodriguez
2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Dan Chen ◽  
Dan Huang ◽  
Taotao Hu ◽  
Fang Chen

Objective. To study the efficacy of restricting dietary protein intake combined with Buyang Huanwu decoction in treating diabetic nephropathy (DN) and its effect on patients’ inflammatory factor levels. Methods. The medical data of 150 DN patients treated in Wuhan No.1 Hospital (June 2018—May 2021) were retrospectively analyzed. All patients received regular therapy, those who received the intervention of restricting dietary protein intake were included in the control group (n = 75), and on this basis, those treated with Buyang Huanwu decoction were included in the experimental group (n = 75), so as to scientifically evaluate their efficacy and inflammatory factor levels after treatment. Results. The patients’ general information was not statistically different between the two groups ( P > 0.05 ); after treatment, the experimental group gained remarkably higher marked effective rate and total effective rate of treatment than the control group ( P < 0.05 ); the inflammatory factor levels of all patients were obviously better than before ( P < 0.05 ), and the levels of TNF-α, IL-2, IL-8, IL-4, and IL-10 were obviously lower in the experimental group than in the control group ( P < 0.05 ); the levels of fasting blood glucose, 2 h postprandial blood glucose, and glycosylated hemoglobin of all patients were remarkably lower than before ( P < 0.05 ), but with no significant between-group difference ( P > 0.05 ); the renal function indexes of all patients were better than before, and between the two groups, the levels of 24 h microalbuminuria, 24 h urine protein excretion, and serum creatinine were obviously lower and the glomerular filtration rate was significantly higher in the experimental group ( P all <0.05), and the patients’ traditional Chinese medicine (TCM) symptom scores were remarkably lower in the experimental group ( P < 0.05 ). Conclusion. Jointly applying Buyang Huanwu decoction on the basis of restricting dietary protein intake can effectively promote the clinical efficacy of DN, which is conducive to adjusting the inflammatory factor levels, promoting the patients’ renal function, and alleviating the clinical symptoms.


2003 ◽  
Vol 23 (3) ◽  
pp. 276-283 ◽  
Author(s):  
David W. Johnson ◽  
David W. Mudge ◽  
Joanna M. Sturtevant ◽  
Carmel M. Hawley ◽  
Scott B. Campbell ◽  
...  

♦ Objective The aim of this study was to prospectively evaluate the risk factors for decline of residual renal function (RRF) in an incident peritoneal dialysis (PD) population. ♦ Design Prospective observational study of an incident PD cohort at a single center. ♦ Setting Tertiary-care institutional dialysis center. ♦ Participants The study included 146 consecutive patients commencing PD at the Princess Alexandra Hospital between 1 August 1995 and 1 July 2001 (mean age 54.8 ± 1.4 years, 42% male, 34% diabetic). Patients with failed renal transplants ( n = 26) were excluded. ♦ Main Measurements Timed urine collections ( n = 642) were performed initially and at 6-month intervals thereafter to measure RRF. The development of anuria was also prospectively recorded. ♦ Results The mean (±SD) follow-up period was 20.5 ± 14.8 months. The median slope of RRF decline was –0.05 mL/minute/month/1.73 m2. Using binary logistic regression, it was shown that the 50% of patients with more rapid RRF loss (< –0.05 mL/min/month/1.73 m2) were more likely to have had a higher initial RRF at commencement of PD [adjusted odds ratio (AOR) 1.83, 95% confidence interval (CI) 1.39 – 2.40] and a higher baseline dialysate/plasma creatinine ratio at 4 hours (D/P creat; AOR 44.6, 95% CI 1.05 – 1900). On multivariate Cox proportional hazards model analysis, time from commencement of PD to development of anuria was independently predicted by baseline RRF [adjusted hazard ratio (HR) 0.81, 95% CI 0.60 – 0.81], D/P creat (HR 2.87, 95% CI 2.06 – 82.3), body surface area (HR 6.23, 95% CI 1.53 – 25.5), dietary protein intake (HR 2.87, 95% CI 1.06 – 7.78), and diabetes mellitus (HR 1.65, 95% CI 1.00 – 2.72). Decline of RRF was independent of age, gender, dialysis modality, urgency of initiation of dialysis, smoking, vascular disease, blood pressure, medications (including angiotensin-converting enzyme inhibitors), duration of follow-up, and peritonitis rate. ♦ Conclusions The results of this study suggest that high baseline RRF and high D/P creat ratio are risk factors for rapid loss of RRF. Moreover, a shorter time to the onset of anuria is independently predicted by low baseline RRF, increased body surface area, high dietary protein intake, and diabetes mellitus. Such at-risk patients should be closely monitored for early signs of inadequate dialysis.


2011 ◽  
Vol 81 (23) ◽  
pp. 162-172 ◽  
Author(s):  
Patrice M. Ambühl

The kidney and the liver play a central role in protein metabolism. Synthesis of albumin and other proteins occurs mainly in the liver, whereas protein breakdown and excretion are handled through an intricate interaction between these two organ systems. Thus, disease states of either the liver and/or the kidney invariably result in clinically relevant disturbances of protein metabolism. Conversely, metabolic processes regulated by these two organs are directly affected by dietary protein intake. Of particular importance in this respect is the maintenance of acid/base homeostasis. Finally, both the amount and composition of ingested proteins have a direct impact on renal function, especially in a state of diseased kidneys. Consequently, dietary protein intake is of paramount importance in patients with chronic nephropathy and renal insufficiency. Limitation of ingested protein, particularly from animal sources, is crucial in order to slow the progression of chronic kidney disease and impaired renal function. In contrast, patients with chronic renal failure undergoing renal replacement therapy by hemodialysis or peritoneal dialysis, have an increased protein demand. The syndrome of “protein-energy malnutrition” is a relevant factor for morbidity and mortality in this population and requires early detection and vigorous treatment. Protein intake in patients with cirrhosis of the liver should not be diminished as has been earlier suggested but rather increased to 1.0 - 1.2 g/kg body weight/day, in order to prevent protein malnutrition. Moderate restriction depending on protein tolerance (0.5 - 1.2 g/kg body weight/day), with the possible addition of branched chain amino acids (BCAA), has been recommended only in patients with advanced hepatic encephalopathy. Proteins of plant origin are theoretically superior to animal proteins.


1986 ◽  
Vol 20 (11) ◽  
pp. 842-844 ◽  
Author(s):  
Robert P. Henderson ◽  
Joel O. Covinsky

Studies in animals have indicated that increasing dietary protein intake could increase renal blood flow, glomerular filtration rate, and kidney size and weight. More recent literature suggests that similar findings may be seen in humans with an oral protein load and continuous infusion of amino acids. This paper reviews this body of literature, and examines potential mechanisms involved in producing the observed changes in renal function seen with protein and amino acid administration and potential alterations in drug disposition.


2016 ◽  
Author(s):  
Vladyslav Povoroznyuk ◽  
Nataliia Dzerovych ◽  
Roksolana Povorooznyuk

2018 ◽  
Vol 22 (6) ◽  
pp. 700-709 ◽  
Author(s):  
Marie Fanelli Kuczmarski ◽  
R. T. Pohlig ◽  
E. Stave Shupe ◽  
A. B. Zonderman ◽  
M. K. Evans

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