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Short-term effect of low and high protein intake on renal function in children with renal disease
Insights
High protein intake may boost kidney function in children with moderate renal impairment. This study in children with reduced glomerular filtration rates (GFR) suggests a potential functional reserve capacity.
Area of Science:
- Pediatric Nephrology
- Renal Physiology
Background:
- Children with chronic kidney disease often face challenges related to renal function.
- Understanding the impact of dietary factors like protein intake is crucial for managing pediatric renal conditions.
Purpose of the Study:
- To investigate the short-term effects of varying protein intake levels on renal function in children with moderate to severe chronic kidney disease.
- To assess the potential for functional reserve capacity in response to dietary changes.
Main Methods:
- A clearance method using continuous infusion of inulin and para-aminohippuric acid was employed.
- Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured under uncontrolled, low, and high protein intake conditions.
- The study included 18 children with reduced GFR (51-85 ml/min/1.73 m2 BSA or 9-50 ml/min/1.73 m2 BSA).
Main Results:
- No significant changes in GFR or ERPF were observed during uncontrolled and low protein intake.
- A high protein intake led to a significant increase in GFR and ERPF in children with GFRs above 50 ml/min/1.73 m2 BSA and ERPFs above 150 ml/min/1.73 m2 BSA.
- These improvements suggest a responsive capacity in the kidneys of children with less severe renal impairment.
Conclusions:
- Dietary protein levels can influence renal hemodynamics in children with chronic kidney disease.
- Children with moderately reduced renal function may possess a functional reserve capacity that can be stimulated by a high protein intake.
- Further research is warranted to explore the long-term implications and optimal protein strategies for pediatric renal patients.
Abstract:
The short-term effect of different levels of protein intake on renal function was investigated in 18 children with moderately (51-85 ml/min/1.73 m2 BSA) or severely (9-50 ml/min/1.73 m2 BSA) reduced glomerular filtration rates (GFR). The GFR and effective renal plasma flow (ERPF), estimated as the clearances of respectively inulin and para-aminohippuric acid during uncontrolled (2-2.5 g/kg bw), low (1.2 g/kg bw for 12 days) and high (3-5 g/kg bw for 24 h) protein intake were determined by a standard clearance method employing continuous infusion and spontaneous voiding. There were no significant differences in GFR or ERPF during uncontrolled and low protein intake. During high protein intake the GFR and ERPF increased significantly in patients with GFRs above 50 ml/min/1.73 m2 BSA and ERPFs above 150 ml/min/1.73 m2 BSA. It is concluded that these findings might indicate a functional reserve capacity in children with only moderately reduced renal function.