Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan.
Nutrients. 2020 Aug 23;12(9):2549. doi: 10.3390/nu12092549.
High protein intake can increase glomerular filtration rate (GFR) in response to excretory overload, which may exacerbate the progression of kidney disease. However, the direct association between glomerular hemodynamic response at the single-nephron level and dietary protein intake has not been fully elucidated in humans. In the present study, we evaluated nutritional indices associated with single-nephron GFR (SNGFR) calculated based on corrected creatinine clearance (SNGFR). We retrospectively identified 43 living kidney donors who underwent enhanced computed tomography and kidney biopsy at the time of donation at Jikei University Hospital in Tokyo from 2007 to 2018. Total nephron number was estimated with imaging-derived cortical volume and morphometry-derived glomerular density. SNGFR was calculated by dividing the corrected creatinine clearance by the number of non-sclerosed glomeruli (Nglom). The mean (± standard deviation) Nglom/kidney and SNGFR were 685,000 ± 242,000 and 61.0 ± 23.9 nL/min, respectively. SNGFR was directly associated with estimated protein intake/ideal body weight ( = 0.005) but not with body mass index, mean arterial pressure, albumin, or sodium intake. These findings indicate that greater protein intake may increase SNGFR and lead to glomerular hyperfiltration.
高蛋白饮食可增加肾小球滤过率(GFR)以应对排泄超负荷,这可能加重肾脏疾病的进展。然而,人类肾小球血流动力学反应与膳食蛋白质摄入之间的直接关系尚未完全阐明。在本研究中,我们评估了基于校正肌酐清除率(SNGFR)计算的单肾单位肾小球滤过率(SNGFR)相关的营养指标。我们回顾性地确定了 2007 年至 2018 年期间在东京的顺天堂大学医院接受增强 CT 和肾活检的 43 名活体供肾者。总肾单位数量通过成像衍生的皮质体积和形态学衍生的肾小球密度来估计。通过将校正肌酐清除率除以非硬化肾小球数量(Nglom)来计算 SNGFR。平均(±标准差)Nglom/肾和 SNGFR 分别为 685,000±242,000 和 61.0±23.9 nL/min。SNGFR 与估计的蛋白质摄入/理想体重呈直接相关( = 0.005),但与体重指数、平均动脉压、白蛋白或钠摄入无关。这些发现表明,更多的蛋白质摄入可能会增加 SNGFR 并导致肾小球高滤过。