Nephrology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Botucatu 740, Vila Clementino, CEP 04023-900, São Paulo, SP, Brazil.
Division of Urology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
Urolithiasis. 2017 Oct;45(5):421-428. doi: 10.1007/s00240-017-0975-0. Epub 2017 Mar 22.
Protein supplements are consumed for an expected increase in muscle mass and improved exercise performance, but as their impact on lithogenic parameters are unknown, we aimed to evaluate the effects of Whey protein (WP) and Albumin upon the risk factors for nephrolithiasis. WP or Albumin supplements (one scoop/day) were administered for 3 days to 18 healthy volunteers, with 1-week washout period between them. Serum and 24-h urine samples were collected at baseline and after completing each intervention. All participants were asked to replicate their baseline diet during the subsequent urine collection. After WP or albumin, mean protein equivalent of nitrogen appearance (PNA) was significantly higher (p < 0.001), as the result of the consumption of each of the supplements, but mean urinary calcium, phosphorus, sodium, potassium, uric acid, citrate, oxalate, magnesium, creatinine, pH, and urinary saturation indices did not differ from baseline. However, individual increases higher than 50% in urinary calcium were observed in 39% of the individuals and variable decreases in urinary pH in 44 and 67% of them, respectively, after WP or Albumin. Increases higher than 50% in urinary sodium occurred in one-third of them after Albumin. A short-term consumption of WP or albumin by healthy subjects, under controlled diet, did not significantly change the mean lithogenic parameters. Nevertheless, the wide individual variation and relevant increases/decreases observed for urinary calcium, sodium, and pH suggest the need of a closer surveillance of these parameters and adequacy of diet in case of supplementation by stone formers.
蛋白质补充剂用于预期增加肌肉质量和提高运动表现,但由于其对结石形成参数的影响尚不清楚,我们旨在评估乳清蛋白 (WP) 和白蛋白对肾结石风险因素的影响。WP 或白蛋白补充剂(每天一勺)连续 3 天给予 18 名健康志愿者,其间有 1 周洗脱期。在基线和完成每项干预后采集血清和 24 小时尿液样本。所有参与者被要求在随后的尿液收集期间复制其基线饮食。在 WP 或白蛋白后,由于每种补充剂的消耗,蛋白质等效氮表观量(PNA)的平均值显着增加(p < 0.001),但尿钙、磷、钠、钾、尿酸、柠檬酸盐、草酸盐、镁、肌酐、pH 和尿液饱和度指数与基线相比没有差异。然而,在 WP 或白蛋白后,分别有 39%和 44%和 67%的个体观察到尿钙增加超过 50%,尿 pH 分别有不同程度的降低。在白蛋白后,三分之一的个体尿钠增加超过 50%。在控制饮食的情况下,健康受试者短期摄入 WP 或白蛋白不会显着改变平均结石形成参数。然而,尿钙、钠和 pH 的个体差异较大且观察到相关增加/减少表明需要更密切监测这些参数以及结石形成者补充剂的饮食是否充足。