Remuzzi A, Perticucci E, Battaglia C, D'Amico G, Gentile M G, Remuzzi G
Mario Negri Institute for Pharmacological Research, Bergamo, Italy.
Am J Kidney Dis. 1991 Mar;17(3):317-22. doi: 10.1016/s0272-6386(12)80481-1.
We studied the effect of dietary protein restriction on glomerular function and proteinuria in nine patients with membranous nephropathy. Patients were randomly assigned to a 3-month period of a normal protein diet (NPD, 1.3 mg/kg/d) or of a low-protein diet (LPD, 0.6 mg/kg/d), in a cross-over design. Dietary protein restriction did not affect glomerular filtration rate (47.8 +/- 10.7 and 49.0 +/- 13.5 mL/min/1.73 m2, LPD and NPD, respectively) and renal plasma flow (456 +/- 119 and 499 +/- 161 mL/min/1.73 m2, LPD and NPD, respectively), nor did it significantly improve glomerular permselective function, as shown by urinary protein excretion (3.1 +/- 2.2 and 3.5 +/- 2.8 g/d, LPD and NPD, respectively) and fractional clearance of albumin, IgG, and neutral dextran molecules of graded molecular size (radii ranging from 2.8 to 6.0 nm). These results indicate that reduction of protein intake to 0.6 g/kg/d does not improve glomerular size selectivity in membranous nephropathy. Thus, in current clinical practice, a protein-restricted diet does not appear to be effective in reducing proteinuria in this category of patients.
我们研究了饮食蛋白限制对9例膜性肾病患者肾小球功能和蛋白尿的影响。采用交叉设计，将患者随机分配到正常蛋白饮食（NPD，1.3mg/kg/d）或低蛋白饮食（LPD，0.6mg/kg/d）组，为期3个月。饮食蛋白限制对肾小球滤过率（LPD组和NPD组分别为47.8±10.7和49.0±13.5mL/min/1.73m²）和肾血浆流量（LPD组和NPD组分别为456±119和499±161mL/min/1.73m²）无影响，也未显著改善肾小球的选择通透性，尿蛋白排泄（LPD组和NPD组分别为3.1±2.2和3.5±2.8g/d）以及不同分子大小（半径范围为2.8至6.0nm）的白蛋白、IgG和中性右旋糖酐分子的分数清除率均表明了这一点。这些结果表明，将蛋白摄入量降至0.6g/kg/d并不能改善膜性肾病患者肾小球的大小选择性。因此，在目前的临床实践中，限制蛋白饮食似乎并不能有效降低这类患者的蛋白尿。
