Low protein alimentation normalizes renal haemodynamic response to acute protein ingestion in type 1 diabetic children.
The effect of an acute protein load (2 g kg-1 bodyweight [BW]) was studied in nine type 1 diabetic children. Patients were maintained on two different dietary regimens. In study one, patients were on a high protein diet providing from 2.7 to 1.8 g of protein/kg of BW per day. In study two, patients were reevaluated after three weeks of a diet providing from 1.0 to 1.2 g kg-1 of BW per day of protein. In study one (High Protein Diet), we failed to observe any rise in GFR and RPF following the protein meal (137 +/- 21 basal vs. 110 +/- 14 and 472 +/- 93 basal vs. 494 +/- 93 ml/1.73 m2 of SA min-1 at 60 min. This is in contrast with results from seven age matched controls consuming a free diet, which showed a significant rise in both GFR and RPF. In study two (low protein diet), basal GFR was significantly reduced. However after the protein load, both GFR (92 +/- 11 vs. 126 +/- 18 ml/1.73 m2 of SA min-1) and RPF (467 +/- 83 vs. 705 +/- 102 ml/1.73 m2 min-1) rose significantly (P less than 0.05 vs. basal). The data indicate that: 1. short term protein restriction reduces significantly GFR in type 1 diabetic children; 2. diabetic children maintained on an high protein intake show an altered haemodynamic response to protein ingestion; 3. a normal response to protein ingestion can be restored by short term dietary protein restriction.
Castellino
P
P
Istituto di Medicina Interna e Nefrologia, I Facoltà di Medicina e Chirurgia, Università di Napoli, Italy.
De Santo
N G
NG
Capasso
G
G
Anastasio
P
P
Coppola
S
S
Capodicasa
G
G
Perna
A
A
Torella
R
R
Salvatore
T
T
Giordano
C
C
D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology*; D004044:Dietary Proteins / Q000494:pharmacology*; D005260:Female; D019270:Fructosamine; D005919:Glomerular Filtration Rate; D005934:Glucagon / Q000097:blood; D006595:Hexosamines / Q000097:blood; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D012079:Renal Circulation
D001786:Blood Glucose; D004044:Dietary Proteins; D006595:Hexosamines; D007328:Insulin; D019270:Fructosamine; D005934:Glucagon