Wiegmann T B, Zlomke A M, MacDougall M L, Kipp D E
Kidney and Urology Research Center, Kansas City, KS.
Am J Kidney Dis. 1990 Feb;15(2):147-54. doi: 10.1016/s0272-6386(12)80512-9.
The effect on renal function (creatinine clearance [Ccreat] and inulin clearance [Cinulin]) of changes in chronic dietary protein intake was studied in seven healthy male subjects. Serial 24-hour urine collections were used to determine creatinine excretion (UcreatV) and Ccreat. Subjects were examined after ad libitum (ad lib) food intake and after 2-week periods of high protein diet ([HPD] 1.6 g/kg body weight [BW] per day) and low protein diet ([LPD] 0.5 g/kg BW per day). Inulin clearance (Cinulin) was determined at the end of each 2-week diet period. UcreatV increased from 1,838.8 +/- 97.2 mumol/kg (20.8 +/- 1.1 mg/kg) BW to 2,068.6 +/- 106.1 mumol/kg (23.4 +/- 1.2 mg/kg) BW daily during HPD and decreased significantly to 1,555.9 +/- 167.9 mumol/kg BW per day (17.6 +/- 1.9 mg/kg BW per day) with beginning of LPD. Ccreat rose from 1.54 +/- 0.09 mL/s 1.73 m2 (92.5 +/- 5.5 mL/s.1.73 m2 (104.7 +/- 4.9 mL/min/1.73 m2) during HPD and decreased to 1.23 +/- 0.04 mL/s.1.73 m2 (74.0 +/- 2.2 mL/min/1.73 m2) with initiation of LPD. There was no difference between Cinulin after HPD (1.42 +/- 0.12 mL/s.1.73 m2; 84.9 +/- 7.2 mL/min/1.73 m2) and after LPD (1.36 +/- 0.05 mL/s.1.73 m2; 81.4 +/- 2.9 mL/min/1.73 m2). This study confirms the effect of protein intake on Ccreat and UcreatV, but fails to show an effect of changes in chronic protein intake on glomerular filtration rate (GFR). Ccreat during dietary protein restriction to 0.5 g/kg/d is similar to Cinulin and may be a useful measure of GFR under circumstances where more specific inulin or isotope studies are not available.
在7名健康男性受试者中研究了慢性饮食蛋白质摄入量变化对肾功能（肌酐清除率[Ccreat]和菊粉清除率[Cinulin]）的影响。采用连续24小时尿液收集来测定肌酐排泄量（UcreatV）和Ccreat。在自由进食后以及在高蛋白饮食（[HPD]每天1.6 g/kg体重[BW]）和低蛋白饮食（[LPD]每天0.5 g/kg BW）各2周的时期后对受试者进行检查。在每个2周饮食期结束时测定菊粉清除率（Cinulin）。在HPD期间，UcreatV从每天1838.8±97.2 μmol/kg（20.8±1.1 mg/kg）BW增加至2068.6±106.1 μmol/kg（23.4±1.2 mg/kg）BW，而在LPD开始时显著下降至每天1555.9±167.9 μmol/kg BW（17.6±1.9 mg/kg BW）。Ccreat在HPD期间从1.54±0.09 mL/s·1.73 m2（92.5±5.5 mL/s·1.73 m2；104.7±4.9 mL/min/1.73 m2）上升，而在LPD开始时下降至1.23±0.04 mL/s·1.73 m2（74.0±2.2 mL/min/1.73 m2）。HPD后（1.42±0.12 mL/s·1.73 m2；84.9±7.2 mL/min/1.73 m2）和LPD后（1.36±0.05 mL/s·1.73 m2；81.4±2.9 mL/min/1.73 m2）的Cinulin之间无差异。本研究证实了蛋白质摄入量对Ccreat和UcreatV的影响，但未能显示慢性蛋白质摄入量变化对肾小球滤过率（GFR）的影响。在饮食蛋白质限制至0.5 g/kg/d期间的Ccreat与Cinulin相似，并且在无法进行更特异的菊粉或同位素研究的情况下可能是一种有用的GFR测量指标。
