Cirillo M, Anastasio P, Spitali L, Santoro D, De Santo N G
Nephrology/Department of Pediatrics, Medical School, Second University of Naples, Italy.
Miner Electrolyte Metab. 1998;24(4):279-84. doi: 10.1159/000057382.
Protein ingestion increases renal blood flow and glomerular filtration rate (GFR). This study investigated in healthy adults if the renal response to protein ingestion includes changes in urinary sodium (Na) excretion rate and Na balance. Renal clearance of Na and inulin (used as index of GFR) were measured in 25 healthy adults before (90 min) and after (180 min) a standard meal and, as control, before and after administration of water and Na-chloride (saline). The meal consisted of red lean meat (2 g protein/kg body weight); in control experiments, water and Na were given to match water and Na content of the meal. ANOVA for repeated measures, Student's t-test, and linear regression were used for statistical analysis. GFR and urinary Na excretion increased over baseline after the meal (p < 0.001), not after saline. The post-meal natriuretic response was accounted for an early (0-90 min) increase in glomerular filtered load of Na (p < 0.001) and a late (90-180 min) reduction in tubular Na reabsorption (p < 0.02). Urine flow rate and plasma Na did not significantly change after the meal and in control experiments. Analysis of Na balance showed that post-meal Na excretion was significantly higher than baseline also after Na balance returned to pre-meal values. In healthy individuals, a meat meal stimulates natriuresis and causes a net decrease in Na balance. The renal natriuretic response to the meal appears secondary to the meal-induced changes in renal hemodynamics. The data are in keeping with the hypothesis that dietary protein intake affects also renal Na handling.
摄入蛋白质会增加肾血流量和肾小球滤过率(GFR)。本研究调查了在健康成年人中,肾脏对蛋白质摄入的反应是否包括尿钠(Na)排泄率和钠平衡的变化。在25名健康成年人中,于标准餐进食前(90分钟)和进食后(180分钟)测量钠和菊粉(用作GFR指标)的肾清除率,并作为对照,在给予水和氯化钠(盐水)前后进行测量。餐食由红色瘦肉(2克蛋白质/千克体重)组成;在对照实验中,给予水和钠以匹配餐食中的水和钠含量。采用重复测量方差分析、学生t检验和线性回归进行统计分析。餐后GFR和尿钠排泄量较基线增加(p < 0.001),而给予盐水后未增加。餐后利钠反应归因于早期(0 - 90分钟)肾小球滤过钠负荷增加(p < 0.001)和后期(90 - 180分钟)肾小管钠重吸收减少(p < 0.02)。餐后和对照实验中尿流率和血浆钠无显著变化。钠平衡分析表明,餐后钠排泄量在钠平衡恢复到餐前值后也显著高于基线。在健康个体中,一顿肉餐会刺激利钠作用并导致钠平衡净减少。肾脏对餐食的利钠反应似乎继发于餐食诱导的肾脏血流动力学变化。这些数据与膳食蛋白质摄入也会影响肾脏钠处理的假设一致。