title: High-calorie diet with moderate protein restriction prevents cachexia and ameliorates oxidative stress, inflammation and proteinuria in experimental chronic kidney disease.
abstract: BACKGROUND
  In earlier studies we found that a high-fat, high-energy diet (HFED) attenuates proteinuria, azotemia and lipid accumulation in the remnant kidney of rats subjected to 5/6 nephrectomy. This study was conducted to explore the mechanism of the salutary effect of HFED in association with moderate protein restriction in this model.
  
  
  METHODS
  The 5/6 nephrectomized male rats were randomized to receive regular rat chow (CRF group, n = 6) or HFED diet (CRF + HFED, n = 7) for 12 weeks. Sham-operated rats served as controls (n = 6).
  
  
  RESULTS
  The CRF group exhibited azotemia, hypertension, proteinuria, diminished body weight, oxidative stress, glomerulosclerosis, tubulo-interstitial inflammation and upregulation of pro-oxidant [NAD(P)H oxidase], pro-inflammatory (NF-κB activation, increased MCP-1, lipoxygenase, ICAM-1, VCAM-1), pro-fibrotic (TGF-β, CTGF) and pro-apoptotic pathways (Bax, caspase-3) in the remnant kidney. Consumption of the HFED resulted in a 66% increment in lipid intake, 8% increment in carbohydrate intake and a 24% reduction in protein intake. The CRF + HFED group gained weight normally, had increments in leptin and adiponectin levels, and despite increments in plasma cholesterol and fatty acids, showed significant attenuation of oxidative stress, proteinuria and inflammation, and partial reversal of the remnant kidney upregulation of pro-oxidant, pro-inflammatory, pro-fibrotic and pro-apoptotic pathways.
  
  
  CONCLUSIONS
  Consumption of high-energy diet in association with mild protein restriction results in suppression of upregulated pathways that drive progression of renal injury in the remnant kidney model. These findings may have relevance in the management of chronic kidney disease in humans.
authors.affiliation: Division of Nephrology and Hypertension, Department of Medicine, University of California, Irvine, CA, USA.
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Kim
authors.forename: Nosratola D
authors.initials: ND
authors.lastname: Vaziri
authors.forename: Keith
authors.initials: K
authors.lastname: Norris
authors.forename: Won Suk
authors.initials: WS
authors.lastname: An
authors.forename: Yasmir
authors.initials: Y
authors.lastname: Quiroz
authors.forename: Bernardo
authors.initials: B
authors.lastname: Rodriguez-Iturbe
mesh_terms: D052242:Adiponectin / Q000097:blood; D000818:Animals; D002100:Cachexia / Q000517:prevention & control*; D053148:Caspase 3 / Q000378:metabolism; D003404:Creatinine / Q000097:blood; D018753:Diet, Protein-Restricted; D004041:Dietary Fats / Q000008:administration & dosage*; D002149:Energy Intake; D007249:Inflammation / Q000503:physiopathology / Q000517:prevention & control*; D020738:Leptin / Q000097:blood; D008297:Male; D019950:Mitogen-Activated Protein Kinase 1 / Q000378:metabolism; D048052:Mitogen-Activated Protein Kinase 3 / Q000378:metabolism; D052248:Nitric Oxide Synthase Type I / Q000378:metabolism; D052250:Nitric Oxide Synthase Type III / Q000378:metabolism; D018384:Oxidative Stress / Q000187:drug effects*; D011507:Proteinuria / Q000503:physiopathology*; D051381:Rats; D017392:Thiobarbituric Acid Reactive Substances / Q000378:metabolism; D051028:bcl-2-Associated X Protein / Q000378:metabolism
chemical_list: D052242:Adiponectin; D004041:Dietary Fats; D020738:Leptin; D017392:Thiobarbituric Acid Reactive Substances; D051028:bcl-2-Associated X Protein; D003404:Creatinine; D052248:Nitric Oxide Synthase Type I; D052250:Nitric Oxide Synthase Type III; C496316:Nos3 protein, rat; D019950:Mitogen-Activated Protein Kinase 1; D048052:Mitogen-Activated Protein Kinase 3; D053148:Caspase 3
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