Dietary protein, blood pressure and renal function in renal transplant recipients.
Hypertension is highly prevalent among renal transplant recipients (RTR) and a risk factor for graft failure and cardiovascular events. Protein intake has been claimed to affect blood pressure (BP) in the general population and may affect renal function. We examined the association of dietary protein with BP and renal function in RTR. We included 625 RTR (age 53 (SD 13) years; 57% male). Protein intake was assessed with a FFQ, differentiating between animal and plant protein. BP was measured according to a strict protocol. Creatinine clearance and albuminuria were measured as renal parameters. Protein intake was 83 (SD 12) g/d, of which 63% derived from animal sources. BP was 136 (SD 17) mmHg systolic (SBP) and 83 (SD 11) mmHg diastolic (DBP). Creatinine clearance was 66 (SD 26) ml/min; albuminuria 41 (10-178) mg/24 h. An inverse, though statistically insignificant, association was found between the total protein intake and both SBP (β = - 2·22 mmHg per SD, P= 0·07) and DBP (β = - 0·48 mmHg per SD, P= 0·5). Protein intake was not associated with creatinine clearance. Although albuminuria was slightly higher in the highest tertile of animal protein intake compared with the lowest tertile (66 v. 33 mg/d, respectively, P= 0·03), linear regression analyses did not reveal significant associations between dietary protein and albuminuria. Protein intake exceeded the current recommendations. Nevertheless, within the range of protein intake in our RTR population, we found no evidence for an association of dietary protein with BP and renal function. Intervention studies focusing on different protein types are warranted to clarify their effect on BP and renal function in RTR.
Top Institute Food and Nutrition, Wageningen, The Netherlands. e.van.den.berg@umcg.nl
Else
E
van den Berg
Mariëlle F
MF
Engberink
Elizabeth J
EJ
Brink
Marleen A
MA
van Baak
Rijk O B
RO
Gans
Gerjan
G
Navis
Stephan J L
SJ
Bakker
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000097:blood*; D001794:Blood Pressure; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood*; D003430:Cross-Sectional Studies; D004044:Dietary Proteins / Q000378:metabolism*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000652:urine; D011795:Surveys and Questionnaires; D014508:Urea / Q000652:urine
D004044:Dietary Proteins; D014508:Urea; D003404:Creatinine