A method for estimating nitrogen intake of patients with chronic renal failure

Maroni, Bradley J.; Steinman, Theodore I.; Mitch, William E.

doi:10.1038/ki.1985.10

Cited by 720 publications

(383 citation statements)

References 35 publications

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“…The estimated concentration at time zero was used to calculate plasma volume by standard dilution formula: plasma volume (ml) = dose of Evans Blue dye (μg) injected/serum concentration of Evans Blue dye (μg/ml) extrapolated at time zero [17]. Dietary protein intake in diabetic patients and compliance with the diet were evaluated from weekly determination of 24 h urinary nitrogen excretion according to the formula: urinary nitrogen = urine urea nitrogen + non-urea nitrogen, where 1 g urinary nitrogen=6.25 g protein, and non-urea nitrogen excretion=30 mg kg −1 day −1 [23]. Urinary protein loss was added to the above formula.…”

Section: Methodsmentioning

confidence: 99%

Effects of dietary protein restriction on albumin and fibrinogen synthesis in macroalbuminuric type 2 diabetic patients

et al. 2007

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Aims/hypothesis Diabetic nephropathy is associated with hypoalbuminaemia and hyperfibrinogenaemia. A lowprotein diet has been recommended in patients with diabetic nephropathy, but its effects on albumin and fibrinogen synthesis are unknown. Methods We compared the effects of a normal (NPD; 1.38± 0.08 g kg −1 day −1 ) or low (LPD; 0.81±0.04 g kg −1 day −1 ) -protein diet on endogenous leucine flux (ELF), albumin and fibrinogen synthesis (L-[5,5,5,-2 H 3 ]leucine infusion), and markers of inflammation in nine type 2 diabetic patients with macroalbuminuria. Six healthy participants on NPD served as control participants. Results In comparison with healthy participants, type 2 diabetic patients on an NPD had similar ELF, reduced serum albumin (38±1.1 vs 42±0.8 g/l; p<0.05), similar fractional synthesis rates (FSR) and absolute synthesis rates (ASR) of albumin, and both increased plasma fibrinogen concentration [10.7±0.6 vs 7.2±0.5 μmol/l (3.64±0.22 vs 2.45±0.18 g/l); p<0.05] and fibrinogen ASR [11.03±1.17 vs 6.0±1.8 μmol 1.73 m −2 day −1 (3.7±0.4 vs 1.9±0.3 g 1.73 m −2 day −1 ); p< 0.01]. After LPD, type 2 diabetic patients had the following changes in comparison with NPD: reduced proteinuria (2.74±0.4 vs 4.51±0.8 g/day; p<0.05), ELF (1.93±0.08 vs 2.11±0.08 μmol kg −1 min −1 ; p<0.05) and total fibrinogen pool; increased serum albumin (42±1 vs 38±1 g/l; p<0.01) and albumin ASR (14.1±1 vs 9.9±1 g 1.73 m −2 day −1 ; p< 0.05); and reduced plasma IL-6 levels, which were correlated with albumin ASR (r=−0.749; p<0.05). Conclusions/interpretation LPD in type 2 diabetic patients with diabetic nephropathy reduces low-grade inflammatory state, proteinuria, albuminuria, whole-body proteolysis and ASR of fibrinogen, while increasing albumin FSR, ASR and serum concentration. ISRCTN ID no: CCT-NAPN-16911Keywords Absolute synthesis . Albumin . Diabetic nephropathy . Fibrinogen . Fractional synthesis . Leucine . Low-grade inflammation . Low-protein diet . Macroalbuminuria . Type 2 diabetes Abbreviations ASR absolute synthesis rate CRP C-reactive protein ELF endogenous leucine flux FSR fractional synthesis rate KIC α-ketoisocaproic acid LPD low-protein diet Diabetologia (2008) 51:21-28

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Section: Methodsmentioning

confidence: 99%

Effects of dietary protein restriction on albumin and fibrinogen synthesis in macroalbuminuric type 2 diabetic patients

et al. 2007

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“…41 Statistical processing and analysis of dietary data at the INTERMAP International Coordinating Centres: The London International Coordinating Centre has ongoing responsibility for final entry, review, editing, and analyses of data, including conversion of 24-h dietary recall data into nutrients, storage and security of all data, and generation of descriptive and analytic statistics on INTERMAP scientific aims. In this effort, it is aided by senior colleagues at the Chicago International Coordinating Centre.…”

Section: Collection Of Dietary Datafprocess and Quality Controlmentioning

confidence: 99%

INTERMAP: the dietary data—process and quality control

et al. 2003

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The aim of this report is to describe INTERMAP standardized procedures for assessing dietary intake of 4680 individuals from 17 population samples in China, Japan, UK and USA: Based on a common Protocol and Manuals of Operations, standardized collection by centrally trained certified staff of four 24 h dietary recalls, two timed 24-h urines, two 7-day histories of daily alcohol intake per participant; tape recording of all dietary interviews, and use of multiple methods for ongoing quality control of dietary data collection and processing (local, national, and international); one central laboratory for urine analyses; review, update, expansion of available databases for four countries to produce comparable data on 76 nutrients for all reported foods; use of these databases at international coordinating centres to compute nutrient composition. Chinese participants reported 2257 foods; Japanese, 2931; and UK, 3963. In US, use was made of 17 000 food items in the online automated Nutrition Data System. Average time/ recall ranged from 22 min for China to 31 min for UK. Among indicators of dietary data quality, coding error rates (from recoding 10% random samples of recalls) were 2.3% for China, 1.4% for Japan, and UK; an analogous US procedure (re-entry of recalls into computer from tape recordings) also yielded low discrepancy rates. Average scores on assessment of taped dietary interviews were high, 40.4 (Japan) to 45.3 (China) (highest possible score: 48); correlations between urinary and dietary nutrient valuesFsimilar for men and womenF were, for all 4680 participants, 0.51 for total protein, range across countries 0.40-0.52; 0.55 for potassium, range 0.30-0.58; 0.42 for sodium, range 0.33-0.46. The updated dietary databases are valuable international resources. Dietary quality control procedures yielded data generally indicative of high quality performance in the four countries. These procedures were time consuming. Ongoing recoding of random samples of recalls is deemed essential. Use of tape recorded dietary interviews contributed to quality control, despite feasibility problems, deemed remediable by protocol modification. For quality assessment, use of correlation data on dietary and urinary nutrient values yielded meaningful findings, including evidence of special difficulties in assessing sodium intake by dietary methods.

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“…Based on the 24 h excretion of urinary urea, protein intake was estimated by applying the Maroni formula (Maroni et al, 1985). As described previously (Pijls et al, 1999), both at baseline and at the 6-monthly follow-up measurements, freshly voided random urine samples were assessed for signs of urinary tract infections.…”

Section: Other Variablesmentioning

confidence: 99%

Protein restriction, glomerular filtration rate and albuminuria in patients with type 2 diabetes mellitus: a randomized trial

Pijls

Vries

Eijk³

et al. 2002

Eur J Clin Nutr

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Objective: Protein restriction delays the progression of non-diabetic and type 1 diabetic renal disorders. This study assessed whether protein restriction delays the onset or early progression of renal disorders in type 2 diabetes. Design: Randomized controlled trial. Outcomes were albuminuria (mg=24 h) and, as an estimate of the glomerular filtration rate, cimetidine-influenced creatinine clearance. Setting: Primary care. Subjects: Patients with type 2 diabetes and microalbuminuria or at least detectable albuminuria, or a diabetes duration > 5 y. Interventions: The experimental group received dietary counselling on protein restriction (n ¼ 63); a control group (n ¼ 68) received the usual dietary advice. The duration of intervention and follow-up was 28 AE 7 months. Results: After 6 months, protein intake differed only by 0.08 g=kg=day between the study groups. Subsequently, this difference decreased and eventually disappeared. An initial effect of protein restriction on albuminuria in favor of the experimental group was not sustained, and the glomerular filtration rate decreased in the experimental group at a 1.6 AE 2.2 ml=min=1.73 m 2 y lower rate than in the control group (P ¼ 0.5). Comparison of patients in the experimental group with a decrease in protein intake of at least 0.20 g=kg=day, with controls with no decrease, indicated a similarly small and insignificant effect on glomerular filtration rate. Conclusions: It is concluded that, in the longer term prevention or delay of renal damage in patients with type 2 diabetes, protein restriction is neither feasible nor efficacious.

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A method for estimating nitrogen intake of patients with chronic renal failure

Cited by 720 publications

References 35 publications

Effects of dietary protein restriction on albumin and fibrinogen synthesis in macroalbuminuric type 2 diabetic patients

Effects of dietary protein restriction on albumin and fibrinogen synthesis in macroalbuminuric type 2 diabetic patients

INTERMAP: the dietary data—process and quality control

Protein restriction, glomerular filtration rate and albuminuria in patients with type 2 diabetes mellitus: a randomized trial

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