Protein and Renal Function
The federal Dietary Guidelines for Americans recommend an amount of 0.8 g/kg/body wt/d dietary protein intake for healthy adults [19].Although LPDs provide direct benefits to CKD patients, healthcare professionals are concerned about protein-energy malnutrition and protein-energy wasting (PEW) in CKD patients due to inadequate energy intake [26,27].The Modification of Diet in Renal Disease (MDRD) was the largest RCT to examine the hypothesis that dietary protein restriction delays the progression of CKD [PMID 10541304].This study concluded that an HPD might increase SNGFR and induce glomerular hyperfiltration; however, this study is unique by identifying that the analysis of human SNGFR is an exemplary parameter to alterations in renal hemodynamics at the single-nephron level [24].HPDs induce glomerular hyperfiltration, hyperemia, and increased hydraulic pressure, resulting in vasodilation of the afferent arteriole [22].HPDs contribute to progressive glomerular damage, which, combined with the renal deterioration from diseased kidneys may contribute to CKD progression.Oba et al. collected 43 healthy (non-diseased) kidneys from live human donors to examine the effect of an HPD on the single-nephron GFR (SNGFR) [24].Proteinuria declined by 20-50% in CKD patients who adhered to a LPD [26,27].