Effect of various protein diets on growth, renal function, and survival of uremic rats

Kleinknecht, C; Salusky, Isidro B.; Broyer, M.; Gubler, Marie–Claire

doi:10.1038/ki.1979.68

Cited by 151 publications

(55 citation statements)

References 19 publications

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“…Adult stature is usually far below that expected for a child's genetic potential, even with adequate dialysis, treatment of acidosis, administration of phosphate binders, nutritional counseling, and supplemental vitamin D ( 1 , 2). Similar findings have been noted in other animal models of chronic renal insufficiency (3)(4)(5). Disturbances in the growth hormone/somatomedin system have been implicated in the etiology of the reduced growth rates of children with renal insuffi-ciency (6,7 ) ; however, the mechanisms remain unclear.…”

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confidence: 76%

The Effects of Exogenous Rat Growth Hormone Therapy on Growth of Uremic Rats Fed an 8% Protein Diet

et al. 1989

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ABSTRACT. Although the mechanisms underlying the inhibitory effects of chronic renal insufficiency on growth are poorly understood, large doses of growth hormone (GH) have been used to improve growth. The present study examines the effects of rat G H and a reduced (8%) protein diet on 75% nephrectomized weanling rats by measuring changes in growth parameters, food utilization, serum albumin concentration, and muscle water content. Significantly greater improvement in growth was found in the GH-treated uremic rats compared with the uremic controls. The mean percent change in wt, length (nose to tail tip), and cranial biparietal diameter was significantly increased in the GH-treated uremic rats, compared with the uremic controls, but foot length and femur length showed only moderate improvement. Food utilization efficiency and serum albumin concentration were significantly higher in GH-treated uremic rats compared with uremic controls, achieving levels that were not different from sham-operated rats. Muscle water content was not significantly different between GH-treated uremic rats, uremic controls, and sham-operated rats. Thus, rat G H treatment administered a t an early age in mild renal insufficiency significantly improved overall growth, food efficiency, and serum albumin concentrations, despite a low protein diet, suggesting that further evaluation of this form of therapy for growth failure of uremia is warranted. (Pediatr Res 26:204-207, 1989) Abbreviations GH, growth hormone U, uremic control group U + GH, uremic rats treated with growth hormone Growth failure is a major complication of chronic renal insufficiency in children. Adult stature is usually far below that expected for a child's genetic potential, even with adequate dialysis, treatment of acidosis, administration of phosphate binders, nutritional counseling, and supplemental vitamin D ( 1 , 2). Similar findings have been noted in other animal models of chronic renal insufficiency (3)(4)(5). Disturbances in the growth hormone/somatomedin system have been implicated in the etiology of the reduced growth rates of children with renal insuffi- Received February 6, 1989; accepted May 8, 1989. Correspondence Dr. James C. M. Chan, Medical College of Virginia, 1101 E. Marshall St., Richmond, VA 23219.ciency (6, 7 ) ; however, the mechanisms remain unclear. The recent availability of large quantities of recombinant human growth hormone (8) may open new avenues for the treatment of growth retardation in uremic children. Preliminary data suggest that large doses of recombinant growth hormone can improve growth in uremic children (9).Large doses of heterologous growth hormone have been used to overcome the inhibitory effect of uremia on growth in fivesixths nephrectomized rats fed 22-24% protein diets (10, 1 1 ) . With respect to the current concerns regarding the role of high protein intake in the progression of renal damage, the present study was designed to examine the effects of parenteral rat G H in rapidly growing weanling rats with mild chronic ren...

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confidence: 76%

The Effects of Exogenous Rat Growth Hormone Therapy on Growth of Uremic Rats Fed an 8% Protein Diet

et al. 1989

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“…However, a few important problems remain to be elucidated for establishment of therapy with Loads of Different Sources 159 a low-protein diet. For example, it has been reported that musclewasting and malnutrition were often observed associated with a low-protein diet (Kleinknecht et al 1979). To resolve these problems, we tried to examine both the quantity and the quality of proteins.…”

Section: Discussionmentioning

confidence: 99%

Effects of acute protein loads of different sources on renal function of patients with diabetic nephropathy.

Nakamura

Takasawa

Kashara

et al. 1989

Tohoku J. Exp. Med.

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To evaluate effects of acute loading of different proteins on renal function, glomerular filtration rate (GFR), albumin excretion rate (AER), and concentrations of plasma amino acids, 11 normal volunteers and 20 diabetic patients were studied before and after eating 1.0 g/kg body weight of either tuna fish meal or bean curd on separate days. In normal subjects, the mean baseline GFR was 115.8+9.5 ml/min/1.73 m2, and the mean GFRs after ingestion of tuna fish meal were 134.1± 15.5 (1 hr), 146.2 + 18.8 (2 hr), and 157.8±21.2 (3 hr), respectively. GFR did not significantly increase in normal subjects after ingestion of bean curd. GFR in diabetic patients with normoalbuminuria after ingestion of each protein was similar to the response in normal subjects. In diabetic patients with microalbuminuria, GFR did not significantly increase after ingestion of each protein. In diabetes with macroalbuminuria, GFR decreased after ingestion of tuna fish meal and did not significantly change after intake of bean curd. In both normal subjects and diabetic patients, urinary AER did not increase after each kind of protein loading. Plasma concentrations of alanine, glycine, and arginine, known to induce glomerular hyperfiltration, increased to a greater degree after ingestion of tuna fish meal than after administration of bean curd. These findings suggest that responses of GFR to acute protein loading may differ according to the amino acid composition of the protein ingested and to the stage of diabetic nephropathy. Diabetic nephropathy ; GFR ; glomerular hyperfiltration ; proteins of different sources ; composition of amino acids An elevated glomerular filtration rate (GFR) in uncomplicated type 1 (insulin dependent) diabetic patients has been confirmed for many years. As to the clinical significance of this phenomenon, Mogensen (1971Mogensen ( , 1976 recently reported that glomerular hyperfiltration in type 1 diabetes with an early stage of diabetic nephropathy might play an important role in subsequent development of late diabetic nephropathy.Although the exact mechanism that induces glomerular

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“…However, a low-protein diet may cause hypoproteinemia, muscle wasting, or malnutrition (Kleinknecht et al 1979; Motomura et al 1988). Moreover, it has been reported that not all proteins equally induce glomerular hyperfiltration (Dhaene et al 1987).…”

Section: Discussionmentioning

confidence: 99%

Glomerular filtration response to acute loading with protein from different sources in healthy volunteers and diabetic patients.

Nakamura

Yamazaki

Chiba

et al. 1990

Tohoku J. Exp. Med.

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To evaluate the effects of acute protein loading on the glomerular filtration rate, albumin excretion rate and concentration of plasma amino acids, ten healthy volunteers and six type 2 diabetic patients with normoalbuminuria were studied before and after eating 0.7 g/kg body weight of tuna fish, boiled egg white, cheese or tofu (bean curd) on separate days. Furthermore, to study the possible role of glucagon, growth hormone, atrial natriuretic peptide and kallikrein in the responses of glomerular filtration rate to protein, these substances were measured before and after ingestion of tuna fish or egg white in six healthy volunteers. In healthy subjects, glomerular filtration rate increased significantly (p <0.01) from 98.1+4.2 ml/min during the baseline period to 129.9+6.6 ml/min after ingestion of tuna fish. No significant differences were seen between glomerular filtration rate before and after ingestion of egg white, cheese or bean curd. No significant differences were observed between the baseline albumin excretion rate and that after loading with any of the four kinds of protein. Plasma concentrations of alanine, glycine and arginine (amino acids known to induce glomerular hyperfiltration) increased to a greater degree after ingestion of tuna fish than after administration of the other meals. Diabetic subjects and healthy volunteers had similar responses. Plasma glucagon and growth hormone concentrations increased after ingestion of the tuna fish meal or egg white. Plasma atrial natriuretic peptide concentration and urinary kallikrein excretion were unaffected by ingestion of these two kinds of protein. These findings suggest that responses of glomerular filtration rate to acute protein loading may differ depending on the protein ingested, and that these reponses may not be directly induced by glucagon, growth hormone, atrial natriuretic peptide or kallikrein. ----diabetic nephropathy ; acute protein loading ; hyperfiltration ; composition of amino acids

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Effect of various protein diets on growth, renal function, and survival of uremic rats

Cited by 151 publications

References 19 publications

The Effects of Exogenous Rat Growth Hormone Therapy on Growth of Uremic Rats Fed an 8% Protein Diet

The Effects of Exogenous Rat Growth Hormone Therapy on Growth of Uremic Rats Fed an 8% Protein Diet

Effects of acute protein loads of different sources on renal function of patients with diabetic nephropathy.

Glomerular filtration response to acute loading with protein from different sources in healthy volunteers and diabetic patients.

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