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

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          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+/-15 ml/min; urinary protein [Uprot.], 7.2+/-2.2 grams/d) and control subjects completed a crossover comparison of diets providing 0.8 or 1.6 grams protein (plus 1 gram protein/gram Uprot.) and 35 kcal per kg per day. Nitrogen balance (BN) was determined and whole body protein turnover measured during fasting and feeding using intravenous -[1-13C]leucine and intragastric -[5,5, 5- 2H3]leucine. BN was positive in both nephrotic and control subjects consuming either diet and rates of whole-body protein synthesis, protein degradation, and leucine oxidation did not differ between groups. In both nephrotic and control subjects anabolism was due to a suppression of whole-body protein degradation and stimulation of protein synthesis during feeding. The principal compensatory response to dietary protein restriction was a decrease in amino acid oxidation and this response was the same in both groups. With the low protein diet leucine oxidation rates during feeding correlated inversely with Uprot. losses (r = -0.83; P < 0. 05).

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          Author and article information

          Journal
          J. Clin. Invest.
          The Journal of clinical investigation
          American Society for Clinical Investigation
          0021-9738
          0021-9738
          May 15 1997
          : 99
          : 10
          Affiliations
          [1 ] Department of Medicine and George M. O'Brien Research Center for Diseases of the Kidney, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA.
          Article
          10.1172/JCI119432
          508089
          9153292
          00d2997c-aa23-41ad-8928-bbf84985b7ca
          History

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