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      Elevated Dietary Protein Intake Impairs the Renal Hemodynamic Response to Hyperaminoacidemia in Patients with Primary Glomerular Diseases

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          Abstract

          We have evaluated the renal hemodynamic response to a mixed amino acid infusion in 7 control subjects and in 8 patients with primary glomerulonephritis (GN). In order to evaluate the role of dietary protein intake in this response, GN patients were maintained for 3 weeks on two separate dietary regimens providing 130 ± 5 g of protein/day (study 1) and 60 ± 3 g of protein/day (study 2), respectively. Normal subjects were studied while consuming a free diet. In GN patients, following the reduction in dietary protein intake basal RPF and GFR decreased from 589 ± 109 to 422 ± 81 ml/l.73 mVmin (p < 0.01, vs. study 1) and from 75 ± 7 to 70 ± 8 ml/1.73 m<sup>2</sup>/min (p = NS). Filtration fraction rose from 0.14 ± 0.02 to 0.19 ± 0.03 (p < 0.05). In study 1, during amino acid infusion GFR and RPF did not change significantly from baseline (75 ± 7 vs. 66 ± 8 ml/1.73 m<sup>2</sup>/min at 180 min and 589 + 109 vs. 567 ± 102 ml/1.73 m<sup>2</sup>/min, respectively). These results are at variance with data obtained in normal controls in whom both GFR and RPF rose significantly following hyperaminoacidemia. In contrast, when dietary protein intake was reduced, a normal renal hemodynamic response to amino acid infusion was restored (GFR went from 70 ± 8 to 90 ± 18 ml/1.73 m<sup>2</sup>/min and RPF from 422 ± 81 to 517 ± 90 ml/1.73 m<sup>2</sup>/min, both p < 0.05 vs. basal), both absolute and percentage increases were similar to what was observed in controls. These results show that in subjects with primary glomerulopathies elevated dietary protein intake affects renal hemodynamics. Maintenance of dietary protein intake within the recommended dietary allowance preserves a normal renal hemodynamic response to hyperaminoacidemia in these patients.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1991
          1991
          11 December 2008
          : 58
          : 2
          : 164-169
          Affiliations
          aIstituto di Medicina Interna e Nefrologia e bIstituto di Medicina Generale -Terapia Medica e Malattie del Metabolismo, I Facoltà di Medicina e Chirurgia, Università di Napoli, Italia
          Article
          186408 Nephron 1991;58:164–169
          10.1159/000186408
          1865972
          © 1991 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 6
          Categories
          Original Paper

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