Effect of mild dietary protein restriction on urinary protein excretion in patients with renal transplant fibrosis.
In recent studies, it has been demonstrated that strict dietary protein restriction has a beneficial effect on renal transplant patients who show chronic rejection, or transplant fibrosis respectively; however, the protein intake in those investigations usually has been below 0.6 g/kg day, and such a strong restriction may be associated with both a negative nitrogen balance, and low patient compliance. Our study was therefore undertaken to investigate whether the same beneficial effect could be attained with a more moderate dietary protein restriction in renal transplant recipients. In a randomized cross-over study, 14 patients with biopsy-proven transplant fibrosis received a mildly protein restricted diet (0.7 g/kg/day), and a normal protein diet (1.2 g/kg/day) respectively during two 3-week periods. In the patients undergoing moderate protein restriction, a significant reduction in urinary albumin, and total protein excretion, as well as a decrease in albumin/creatinine ratio was observed at the end of the 3-week period when compared to the patients on normal protein diet (p < 0.05). The 51Cr-EDTA-clearance did not differ at the end of each of these dietary periods. In contrast to earlier studies with lower protein intake, the moderate protein restriction in our investigation was not associated with a decrease in serum proteins. In conclusion, a mildly restricted protein intake has also proved effective in significantly reducing the urinary protein excretion in patients with renal transplant fibrosis, yet, without causing decreasing serumprotein-concentrations, which are a sign for a negative nitrogen balance.
Biesenbach
G
G
2nd Department of Medicine, General Hospital, Linz, Austria.
Zazgornik
J
J
Janko
O
O
Hubmann
R
R
Syré
G
G
D000328:Adult; D000419:Albuminuria / Q000178:diet therapy / Q000652:urine; D001798:Blood Proteins / Q000652:urine; D018592:Cross-Over Studies; D018753:Diet, Protein-Restricted; D005260:Female; D006084:Graft Rejection / Q000178:diet therapy* / Q000652:urine; D006801:Humans; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000178:diet therapy* / Q000652:urine; D011507:Proteinuria / Q000178:diet therapy* / Q000652:urine
D001798:Blood Proteins