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Studies in renal response to various protein intakes in preterm infants
Insights
Adding extra protein to breast milk significantly improved kidney function in preterm infants. This high protein diet enhanced glomerular filtration rate and sodium clearance in very low birth weight infants.
Area of Science:
- Neonatal nutrition
- Pediatric nephrology
- Infant kidney function
Background:
- Very low birth weight infants have immature renal systems.
- Optimizing nutrition is crucial for infant development and organ function.
- The impact of protein intake on immature kidneys requires further investigation.
Purpose of the Study:
- To compare the renal effects of standard breast milk versus fortified breast milk with extra protein in preterm infants.
- To assess the influence of dietary protein on glomerular filtration rate (GFR) and sodium handling in immature kidneys.
Main Methods:
- A comparative study involving very low birth weight infants (gestational age 26-30 weeks).
- Infants received either standard breast milk or breast milk fortified with extra human protein (7 g/l).
- Renal function parameters, including GFR, sodium clearance, urine osmolality, and diuresis, were monitored.
Main Results:
- The high protein diet significantly increased glomerular filtration rate (GFR) compared to standard breast milk.
- Sodium clearance increased proportionally to GFR with the high protein diet.
- Moderate increases in urine osmolality were observed with the high protein diet, while diuresis remained unchanged.
Conclusions:
- Dietary protein intake influences the function of the immature kidney in preterm infants.
- Higher protein intake appears beneficial for enhancing renal function parameters in this vulnerable population.
- Long-term renal outcomes associated with high protein intake in preterm infants are yet to be determined.
Abstract:
The renal effects of two diets--breast-milk and breast-milk with extra human protein (7 g/l breast-milk)--were compared in very low birth weight infants with a gestational age of 26 to 30 weeks. When the infants were given the high protein diet for one week the glomerular filtration rate (GFR) increased significantly more than when breast-milk alone was given. Sodium clearance showed a similar increase in proportion to the GFR during the two diets. The high protein diet raised the urine osmolality moderately in all individuals, while the diuresis remained unchanged. The data in the present study indicate that the function of the immature kidney is influenced by the amount of protein in the diet. However, the long-term renal effects in preterm infants maintained on a high protein intake remain unknown.