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Juraschek SP, Appel LJ, Anderson CA, Miller ER 3rd, et al.
American journal of kidney diseases : the official journal of the National Kidney Foundation. Date of publication 2013 Apr 1;volume 61(4):547-54.
1. Am J Kidney Dis. 2013 Apr;61(4):547-54. doi: 10.1053/j.ajkd.2012.10.017. Epub 2012 Dec 4. Effect of a high-protein diet on kidney function in healthy adults: results from the OmniHeart trial. Juraschek SP(1), Appel LJ, Anderson CA, Miller ER 3rd. Author information: (1)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. BACKGROUND: Consumption of a diet high in protein can cause glomerular hyperfiltration, a potentially maladaptive response, which may accelerate the progression of kidney disease. STUDY DESIGN: 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. INTERVENTION: 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. OUTCOMES: Fasting serum creatinine, cystatin C, and β2-microglobulin levels, estimated glomerular filtration rate (eGFR). MEASUREMENTS: Serum creatinine, cystatin C, and β2-microglobulin collected at the end of each feeding period. RESULTS: 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. LIMITATIONS: Participants did not have kidney disease at baseline. CONCLUSIONS: A healthy diet rich in protein increased eGFR. Whether long-term consumption of a high-protein diet leads to kidney disease is uncertain. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved. DOI: 10.1053/j.ajkd.2012.10.017 PMCID: PMC3602135 PMID: 23219108 [Indexed for MEDLINE]
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