Johns Hopkins School of Medicine, Johns Hopkins Bloomberg School of Public Health, and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD 21205, USA.
Am J Kidney Dis. 2013 Apr;61(4):547-54. doi: 10.1053/j.ajkd.2012.10.017. Epub 2012 Dec 4.
Consumption of a diet high in protein can cause glomerular hyperfiltration, a potentially maladaptive response, which may accelerate the progression of kidney disease.
An ancillary study of the OmniHeart trial, a randomized 3-period crossover feeding trial testing the effects of partial replacement of carbohydrate with protein on kidney function.
SETTING & PARTICIPANTS: Healthy adults (N=164) with prehypertension or stage 1 hypertension at a community-based research clinic with a metabolic kitchen.
Participants were fed each of 3 diets for 6 weeks. Feeding periods were separated by a 2- to 4-week washout period. Weight was held constant on each diet. The 3 diets emphasized carbohydrate, protein, or unsaturated fat; dietary protein was either 15% (carbohydrate and unsaturated fat diets) or 25% (protein diet) of energy intake.
Fasting serum creatinine, cystatin C, and β2-microglobulin levels, estimated glomerular filtration rate (eGFR).
Serum creatinine, cystatin C, and β2-microglobulin collected at the end of each feeding period.
Baseline cystatin C-based eGFR was 92.0±16.3 (SD) mL/min/1.73 m(2). Compared with the carbohydrate and unsaturated fat diets, the protein diet increased cystatin C-based eGFR by ~4 mL/min/1.73 m(2) (P < 0.001). The effects of the protein diet on kidney function were independent of changes in blood pressure. There was no significant difference between the carbohydrate and unsaturated fat diets.
Participants did not have kidney disease at baseline.
A healthy diet rich in protein increased eGFR. Whether long-term consumption of a high-protein diet leads to kidney disease is uncertain.
高蛋白饮食可导致肾小球高滤过，这是一种潜在的适应不良反应，可能加速肾脏疾病的进展。
OmniHeart 试验的辅助研究，这是一项随机 3 期交叉喂养试验，旨在测试用蛋白质部分替代碳水化合物对肾功能的影响。
社区研究诊所和代谢厨房中患有高血压前期或 1 期高血压的健康成年人（N=164）。
参与者接受了 3 种饮食中的每一种 6 周。喂养期之间有 2-4 周的洗脱期。在每种饮食中保持体重不变。3 种饮食强调碳水化合物、蛋白质或不饱和脂肪；饮食中的蛋白质分别占能量摄入的 15%（碳水化合物和不饱和脂肪饮食）或 25%（蛋白质饮食）。
空腹血清肌酐、胱抑素 C 和 β2-微球蛋白水平、估算肾小球滤过率（eGFR）。
在每个喂养期结束时收集血清肌酐、胱抑素 C 和 β2-微球蛋白。
基线时基于胱抑素 C 的 eGFR 为 92.0±16.3（SD）mL/min/1.73 m(2)。与碳水化合物和不饱和脂肪饮食相比，蛋白质饮食使基于胱抑素 C 的 eGFR 增加了约 4 mL/min/1.73 m(2)（P < 0.001）。蛋白质饮食对肾功能的影响与血压变化无关。碳水化合物和不饱和脂肪饮食之间无显著差异。
参与者在基线时没有肾脏疾病。
富含蛋白质的健康饮食可增加 eGFR。长期摄入高蛋白饮食是否会导致肾脏疾病尚不确定。
