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Does enteral protein intake affect renal glomerular and tubular functions in very low birth weight infants?

Hayriye Gozde Kanmaz, Banu Mutlu, Omer Erdeve

    Clinical Nephrology
    |October 5, 2013
    PubMed

    Insights

    Higher protein intake in very low birth weight infants did not impair kidney function. This study found no significant differences in renal markers with increased enteral protein fortification up to 3.6 g/kg/day.

    Area of Science:

    • Neonatalogy
    • Pediatric Nephrology
    • Nutritional Science

    Background:

    • Very low birth weight infants require high protein intake (3-4 g/kg/day) for optimal growth and neurodevelopment.
    • These infants have reduced functional nephrons, increasing susceptibility to renal dysfunction.
    • Optimal protein fortification strategies are crucial to balance growth needs with renal safety.

    Purpose of the Study:

    • To investigate the impact of varying enteral protein fortification levels on renal glomerular and tubular function in preterm infants.
    • To assess serum urea, creatinine, Cystatin C, and urinary β2 microglobulin levels across different protein intake groups.

    Main Methods:

    • Randomized controlled trial involving preterm infants.
    • Three groups received standard (3 g/kg/d), moderate (3.3 g/kg/d), or aggressive (3.6 g/kg/d) protein fortification.
    • Renal function markers were measured on discharge and postnatal Day 14.

    Main Results:

    • No significant differences in serum urea, creatinine, Cystatin C, or urinary β2 microglobulin were observed between the three protein intake groups.
    • Mean creatinine and β2 microglobulin levels were lower at discharge across all groups.
    • Cystatin C levels showed no significant change over time.

    Conclusions:

    • Enteral protein intake up to 3.6 g/kg/day appears safe regarding short-term renal glomerular and tubular function in very preterm infants.
    • Long-term renal outcomes in infants receiving high protein intake require further investigation.
    Abstract

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