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Renal Response to a Protein Load in Healthy Young Adults as Determined by Iohexol Infusion Clearance, Cimetidine-Inhibited Creatinine Clearance, and Cystatin C Estimated Glomerular Filtration Rate.
- Source :
-
Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation [J Ren Nutr] 2017 Jul; Vol. 27 (4), pp. 275-281. Date of Electronic Publication: 2017 Apr 25. - Publication Year :
- 2017
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Abstract
- Objective: Renal reserve (RR) measures the increase in glomerular filtration rate (GFR) in response to a protein load; lack of RR could indicate subclinical kidney disease but such a test is not routinely used in clinical practice. The purpose of this study was to compare a meat versus liquid protein load in a cystatin C-based (Cys-C) RR test using cimetidine-inhibited creatinine clearance (Cr Cl) and iohexol infusion clearance (Io Cl) for validation. The design was cross-sectional analysis and the setting was a Clinical Research Center.<br />Subjects: Participants (N = 16), mean (standard deviation [SD]) age 22 (2) years, had normal health and blood pressure without proteinuria.<br />Intervention: Participants 1 to 8 received a beef burger (1 g/kg protein) and participants 9 to 16 received a ProCel shake (1-1.5 g/kg protein).<br />Main Outcome Measure: RR defined as the difference in stimulated versus baseline GFR.<br />Results: Baseline GFR (SD) in mL/minute/1.73 m <superscript>2</superscript> averaged 103.0 (15.6) for Cr Cl, 94.8 (7.9) for Io Cl, and 117.0 (6.0) for Cys-C estimated GFR (eGFR). Mean RR (SD) for the burger group (N = 8, mL/minute/1.73 m <superscript>2</superscript> ) was 16.6 (12.3) for Cr Cl (P = .006); 7.2 (3.7) for Io Cl (P < .001), and 4.9 (2.6) for Cys-C eGFR (P = .001). Mean RR for the shake group (N = 8) was 15.8 (5.8) for Cr Cl (P < .001), 10.1 (7.8) for Io Cl (P = .008), and 2.4 (2.9) for Cys-C eGFR (P = .05).<br />Conclusion: Protein loading stimulates Io Cl and Cr Cl after a beef or milk-based protein load. The change in Cys-C eGFR is significant but smaller for the shake and burger group, which may be due to the dilutional effect of water loading or the length of Cys-C half-life in the blood.<br /> (Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 1532-8503
- Volume :
- 27
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation
- Publication Type :
- Academic Journal
- Accession number :
- 28389059
- Full Text :
- https://doi.org/10.1053/j.jrn.2017.01.021