Glomerular and hormonal responses to dietary protein intake in human renal disease.
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.
D015121:6-Ketoprostaglandin F1 alpha / Q000652:urine; D000328:Adult; D000450:Aldosterone / Q000097:blood; D001798:Blood Proteins / Q000378:metabolism; D003911:Dextrans / Q000378:metabolism; D003928:Diabetic Nephropathies / Q000503:physiopathology; D004044:Dietary Proteins / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D005921:Glomerulonephritis / Q000503:physiopathology*; D006439:Hemodynamics; D006728:Hormones / Q000097:blood*; D006801:Humans; D007668:Kidney / Q000098:blood supply; D007676:Kidney Failure, Chronic / Q000503:physiopathology; D007678:Kidney Glomerulus / Q000187:drug effects / Q000503:physiopathology*; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D011458:Prostaglandins E / Q000652:urine; D011507:Proteinuria / Q000652:urine; D012083:Renin / Q000097:blood
D001798:Blood Proteins; D003911:Dextrans; D004044:Dietary Proteins; D006728:Hormones; D011458:Prostaglandins E; D000450:Aldosterone; D015121:6-Ketoprostaglandin F1 alpha; D012083:Renin