Glomerular and hormonal responses to dietary protein intake in human renal disease

Am J Physiol. 1987 Dec;253(6 Pt 2):F1083-90. doi: 10.1152/ajprenal.1987.253.6.F1083.

Abstract

The effects of dietary protein on glomerular and hormonal function were studied in twelve adults with a variety of glomerular diseases. They were randomly assigned, using a crossover design, to two 11-day periods, one on a high-protein diet (2 g.kg-1.day-1) and the other on a low-protein diet (0.55 g.kg-1.day-1). Improvement in glomerular permselectivity on the low-protein diet was manifested by a decreased 24-h urinary excretion of total protein, albumin, and IgG by 33, 40, and 25%, respectively (all P less than 0.02); a fall in the fractional clearance of albumin (10.1 +/- 6.3 X 10(-3) to 5.8 +/- 3.3 X 10(-3)), and IgG (6.9 +/- 5.1 X 10(-3) to 3.5 +/- 2.3 X 10(-3)) (both P less than 0.02); and a decreased fractional clearance of neutral dextrans of molecular radii 48-56 A (P less than 0.05), when measured on the final day of each dietary period. The high-protein diet was accompanied by a higher plasma renin activity (6.9 +/- 1.6 vs. 3.5 +/- 0.8 ng angiotensin I.ml-1.h-1) (P less than 0.02), and increased excretion of prostaglandin E and 6-ketoprostaglandin F1 alpha. We conclude that a low-protein diet rapidly improves the size-selective defect in glomerular permselectivity.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • 6-Ketoprostaglandin F1 alpha / urine
  • Adult
  • Aldosterone / blood
  • Blood Proteins / metabolism
  • Dextrans / metabolism
  • Diabetic Nephropathies / physiopathology
  • Dietary Proteins / administration & dosage
  • Dietary Proteins / pharmacology*
  • Female
  • Glomerulonephritis / physiopathology*
  • Hemodynamics
  • Hormones / blood*
  • Humans
  • Kidney / blood supply
  • Kidney Failure, Chronic / physiopathology
  • Kidney Glomerulus / drug effects
  • Kidney Glomerulus / physiopathology*
  • Male
  • Metabolic Clearance Rate
  • Middle Aged
  • Prostaglandins E / urine
  • Proteinuria / urine
  • Renin / blood

Substances

  • Blood Proteins
  • Dextrans
  • Dietary Proteins
  • Hormones
  • Prostaglandins E
  • Aldosterone
  • 6-Ketoprostaglandin F1 alpha
  • Renin