Top Institute Food and Nutrition, Wageningen, The Netherlands.
Br J Nutr. 2013 Apr 28;109(8):1463-70. doi: 10.1017/S0007114512003455. Epub 2012 Aug 21.
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.
高血压在肾移植受者（RTR）中非常普遍，是移植物失败和心血管事件的危险因素。有研究声称，蛋白质的摄入量会影响普通人群的血压（BP），并可能影响肾功能。我们研究了 RTR 患者的饮食蛋白与 BP 和肾功能之间的关系。我们纳入了 625 名 RTR（年龄 53（SD 13）岁；57%为男性）。采用 FFQ 评估蛋白质摄入量，并区分动物蛋白和植物蛋白。按照严格的方案测量 BP。用肌酐清除率和蛋白尿作为肾功能参数进行测量。蛋白质摄入量为 83（SD 12）g/d，其中 63%来自动物来源。SBP 为 136（SD 17）mmHg，DBP 为 83（SD 11）mmHg。肌酐清除率为 66（SD 26）ml/min；蛋白尿 41（10-178）mg/24 h。总蛋白摄入量与 SBP（β = - 2·22mmHg/SD，P= 0·07）和 DBP（β = - 0·48mmHg/SD，P= 0·5）呈负相关，但无统计学意义。蛋白质摄入量与肌酐清除率无关。尽管与最低三分位组相比，动物蛋白摄入量最高三分位组的蛋白尿略高（分别为 66 与 33mg/d，P= 0·03），但线性回归分析并未显示饮食蛋白与蛋白尿之间存在显著相关性。蛋白质摄入量超过了目前的推荐量。尽管如此，在我们的 RTR 人群的蛋白质摄入量范围内，我们没有发现饮食蛋白与 BP 和肾功能之间存在关联的证据。有必要开展针对不同蛋白质类型的干预研究，以阐明它们对 RTR 患者 BP 和肾功能的影响。
