Effect of a High Protein Diet in Patients with the Nephrotic Syndrome

1989 ◽  
Vol 77 (4) ◽  
pp. 445-451 ◽  
Author(s):  
H. Mansy ◽  
T. H. J. Goodship ◽  
J. S. Tapson ◽  
G. H. Hartley ◽  
Pauline Keavey ◽  
...  
Keyword(s):  
Body Weight ◽  
Nephrotic Syndrome ◽  
Plasma Renin Activity ◽  
Ideal Body Weight ◽  
Plasma Renin ◽  
Serum Phosphate ◽  
Renin Activity ◽  
Protein Diet ◽  
Dietary History ◽  
Ideal Body

1. Twelve patients with the nephrotic syndrome were prescribed for 4 week periods a normal protein diet (NPD) containing 1 g of protein/kg ideal body weight. They were then prescribed for further 4 week periods in random order diets with high (HPD) and low (LPD) protein contents, respectively 2.0 and 0.5 g/kg ideal body weight. 2. Compliance was confirmed by dietary history and measurement of urinary urea excretion. 3. Serum albumin was the same on all diets. Twenty-four hour urinary protein excretion increased progressively with increasing dietary protein (LPD 6.1 g, NPD 8.2 g, HPD 9.2 g). Recumbent plasma renin activity and serum phosphate were significantly increased on HPD (plasma renin activity: LPD 5.7, NPD 4.6, HPD 8.2 pmol of angiotensin I min−1 I−1; serum phosphate: LPD 1.27, NPD 1.26, HPD 1.41 mmol/l). 4. There was no evidence of protein-induced hyperfiltration or hyperperfusion: 51Cr-ethylenediaminetetraacetate and [125I]iodohippurate clearances were similar on all three diets. 5. Since proteinuria, increased plasma renin levels and hyperphosphataemia may contribute to progression of renal failure and because HPD did not improve hypoalbuminaemia, the use of HPD in the nephrotic syndrome should be abandoned. 6. Until it can be established that LPD, which is accompanied by the least proteinuria, does not, with long-term feeding, lead to malnutrition, NPD should be used in the treatment of the nephrotic syndrome.

scholarly journals Anti-Xa Activity of Enoxaparin for Prevention of Venous Thromboembolism in Severe Nephrotic Syndrome—A Single Center Prospective Study

2021 ◽  
Vol 10 (23) ◽  
pp. 5709
Author(s):  
Anna Matyjek ◽  
Aleksandra Rymarz ◽  
Zuzanna Nowicka ◽  
Slawomir Literacki ◽  
Tomasz Rozmyslowicz ◽  
...  
Keyword(s):  
Body Weight ◽  
Nephrotic Syndrome ◽  
Dose Adjustment ◽  
Ideal Body Weight ◽  
Optimal Dose ◽  
Fixed Dose ◽  
Bivariate Model ◽  
Risk Threshold ◽  
Venous Thromboembolic Events ◽  
Ideal Body

Severe nephrotic syndrome (NS) is associated with high risk of venous thromboembolic events (VTE), as well as presumably altered heparin pharmacokinetics and pharmacodynamics. Although prophylactic anticoagulation is recommended, the optimal dose is not established. The aim of the study was to test two co-primary hypotheses: of reduced enoxaparin effectiveness and of the need for dose-adjustment in NS. Forty two nephrotic patients with serum albumin ≤2.5 g/dL were alternately assigned to a standard fixed-dose of enoxaparin (NS-FD: 40 mg/day) or ideal body weight (IBW)-based adjusted-dose (NS-AD: 1 mg/kg/day). Twenty one matched non-proteinuric individuals (C-FD) also received fixed-dose. Co-primary outcomes were: the achievement of low- and high-VTE risk threshold of antifactor-Xa activity (anti-FXa) defined as 0.2 IU/mL and 0.3 IU/mL, respectively. Low-VTE-risk threshold was achieved less often in NS-FD than C-FD group (91 vs. 62%, p = 0.024), while the high-VTE-risk threshold more often in NS-AD than in NS-FD group (90 vs. 38%, p < 0.001). Two VTE were observed in NS during 12 months of follow-up (incidence: 5.88%/year). In both cases anti-FXa were 0.3 IU/mL implying the use of anti-FXa >0.3 IU/mL as a target for dose-adjustment logistic regression models. We determined the optimal dose/IBW cut-off value at 0.8 mg/kg and further developed bivariate model (termed the DoAT model) including dose/IBW and antithrombin activity that improved the diagnostic accuracy (AUC 0.85 ± 0.06 vs. AUC 0.75 ± 0.08). Enoxaparin efficacy is reduced in severe NS and the dose should be adjusted to ideal body weight to achieve target anti-FXa activity.

Influence of Family History of Hypertension on the Relationships between Blood Pressure, Body Weight, Electrolyte Metabolism, Renin, Prolactin and Parathormone

1981 ◽  
Vol 61 (s7) ◽  
pp. 359s-362s ◽  
Author(s):  
F. Wessels ◽  
D. Hoffmann ◽  
H. Wagner ◽  
H. Zumkley
Keyword(s):  
Blood Pressure ◽  
Body Weight ◽  
Family History ◽  
Plasma Renin Activity ◽  
Systolic Blood Pressure ◽  
Plasma Renin ◽  
Renin Activity ◽  
Creatinine Ratio ◽  
History Of ◽  
Family History Of Hypertension

1. The influence of family history of hypertension on the relationships between blood pressure, relative body weight, sodium/creatinine ratio of the 24 h urine, plasma renin activity and the plasma concentration of prolactin and parathormone were examined in 102 healthy male students. 2. Grouping together results from all students showed significant positive correlations between systolic blood pressure and prolactin, parathormone as well as relative body weight, between plasma renin activity and prolactin and a significant negative correlation between plasma renin activity and sodium/creatinine ratio of the 24 h urine. 3. By dividing the students into two groups according to their family history of hypertension we could demonstrate in those with family history of hypertension a highly significant positive correlation between mean blood pressure and sodium/creatinine ratio of the 24 h urine and an improvement of the correlations between systolic blood pressure and prolactin and between sodium/creatinine ratio of the 24 h urine and plasma renin activity. In students without family history of hypertension these relationships were no longer detectable. In the students without family history of hypertension the correlations between systolic blood pressure and relative body weight as well as between plasma renin activity and prolactin gained substantially in significance. In students with positive family history of hypertension these correlations could no longer be demonstrated. The correlations between systolic blood pressure and parathormone remained unaffected by family history of hypertension. 4. The results suggest that a genetic predisposition to essential hypertension is able to intensify the blood pressure effect of Na intake and of prolactin, which, besides its function as a sex hormone, is presumed additionally to be able to retain salt. However, the positive relationship between body weight and blood pressure, as well as between plasma renin activity and prolactin, the significance of which increases greatly in subjects without family history of hypertension, appears to be lost as the result of the increased sensitivity to salt in positive family history of hypertension.

Chronic effects of vasopressin on plasma renin activity in sodium-restricted dogs

1986 ◽  
Vol 250 (3) ◽  
pp. F460-F469
Author(s):  
D. C. Merrill ◽  
A. W. Cowley
Keyword(s):  
Body Weight ◽  
Plasma Renin Activity ◽  
Control Level ◽  
Plasma Catecholamines ◽  
Plasma Renin ◽  
Total Body Weight ◽  
Renin Activity ◽  
Renal Nerves ◽  
Long Term Effects ◽  
Total Body

The effects of chronic (4 days) arginine vasopressin (AVP) infusion were studied in two separate groups of animals: normal Na-restricted dogs with intact renal nerves (n = 8) and renal-denervated Na-restricted dogs (n = 5). Volume expansion during AVP infusion was prevented in these studies with a sensitive servo-controlled cage-scale system. With intravenous AVP infusion (0.36 ng X kg-1 X min-1), plasma AVP levels increased from nearly 3 to 15 pg/ml, whereas total body weight remained unchanged from the control level. In renal-innervated dogs, plasma renin activity (PRA) decreased significantly (P less than 0.05) from control levels of 5.50 +/- 0.61 to an average level of 3.45 +/- 0.76 ng angiotensin I (ANG I) X ml-1 X h-1 on days 1 and 2 of AVP infusion. Thereafter, PRA tended to remain decreased on days 3 and 4, averaging 3.82 +/- 1.02 ng ANG I X ml-1 X h-1, but this was not statistically significant. Urinary Na excretion and balance, however, were not significantly altered during the 4-day AVP infusion period. In renal-denervated dogs, the rise of PRA with Na restriction was 50% that seen in normal dogs. In this group, a transient suppression of PRA was observed on day 1 of AVP infusion from 2.84 +/- 0.75 to 1.46 +/- 0.47 ng ANG I X ml-1 X h-1. Urinary Na excretion increased transiently with a small net Na loss of 4.9 +/- 1.3 meq on day 2 of AVP infusion. No significant changes occurred in average 24-h mean arterial pressure (MAP) in response to AVP in either group of dogs. Thus, in contrast to our previous observations in Na-replete dogs, elevations of plasma AVP within the physiological range result in suppression of PRA, but for periods of no longer than 1-2 days in Na-restricted dogs. This decrease of PRA occurred in the absence of measurable changes in MAP, total body weight, or plasma catecholamines. In addition, this transient AVP-induced suppression of PRA was only partially blunted by prior renal denervation. Finally, in the Na-restricted dog, AVP appears to have minimal or no long-term effects on urinary Na excretion.

Evidence for an Unidentified, Adrenocorticotrophic Hormone-Dependent Mineralocorticoid Maintaining Hypertension in Young Women with Hypoaldosteronism

1978 ◽  
Vol 55 (s4) ◽  
pp. 271s-274s
Author(s):  
W. H. L. Hoefnagels ◽  
J. I. M. Drayer ◽  
J. A. Hofman ◽  
A. G. H. Smals ◽  
TH. J. Benraad ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Weight ◽  
Plasma Renin Activity ◽  
Young Women ◽  
Plasma Renin ◽  
Plasma Potassium ◽  
Renin Activity ◽  
Adrenocorticotrophic Hormone ◽  
Low Renin Hypertension ◽  
Characteristic Features

1. Pronounced hypoaldosteronism was found in five young women with low-renin hypertension and characteristic features of the mineralocorticoid hypertensive syndrome. 2. There was no overproduction of the mineralocorticoids 11-deoxycorticosterone and 18-OH-11-deoxycorticosterone. 3. Dexamethasone restored blood pressure to normal, decreased body weight, increased plasma potassium, and increased plasma renin activity and aldosterone excretion in all patients. 4. The data suggest overproduction of an unknown adrenocorticotrophic hormone-dependent mineralocorticoid maintaining hypertension in these patients.

Ascending Brain-Stem Noradrenergic Pathways Modulate the Renin Response to Haemorrhage

1984 ◽  
Vol 67 (2) ◽  
pp. 269-272 ◽  
Author(s):  
S. L. Lightman ◽  
K. Todd ◽  
B. J. Everitt ◽  
M. J. Brown ◽  
R. C. Causon
Keyword(s):  
Body Weight ◽  
Plasma Renin Activity ◽  
Brain Stem ◽  
Plasma Renin ◽  
Renin Activity ◽  
Intracerebral Injection ◽  
Similar Response ◽  
Cell Groups ◽  
6 Hydroxydopamine ◽  
The Brain

1. Ventral noradrenergic projections (VNAB) from lateral tegmental (A1, A2) and dorsal noradrenergic projections (DNAB) from the coeruleal (A6) as well as A1 cell groups in the brain-stem of the rat were lesioned by intracerebral injection of 6-hydroxydopamine. 2. A marked increase in plasma renin activity and adrenaline concentrations followed haemorrhage (0.5 ml/100 g body weight) in the sham-operated rats. VNAB-lesioned rats showed a similar response to the sham-operated controls, but in DNAB-lesioned animals the rise of plasma renin was markedly attenuated.

Effect of water deprivation on urinary excretion of PGE2 in the dog

1983 ◽  
Vol 245 (3) ◽  
pp. R329-R333 ◽  
Author(s):  
A. Zucker ◽  
A. Nasjletti ◽  
E. G. Schneider
Keyword(s):  
Body Weight ◽  
Plasma Renin Activity ◽  
Urinary Excretion ◽  
Water Deprivation ◽  
Plasma Renin ◽  
Urine Osmolality ◽  
Renin Activity ◽  
Plasma Sodium ◽  
Free Access ◽  
Access To Water

We examined the influence of the state of hydration on the urinary excretion of prostaglandin E2 (PGE2) and kallikrein in the dog. Immunoreactive PGE2 and kallikrein were measured in the urine of conscious dogs during periods of water deprivation and periods of free access to drinking water and in the urine of time-control dogs that had free access to water throughout the study. During water deprivation the excretion of kallikrein did not change significantly, but PGE2 excretion increased by 50 and 75% (P less than 0.05) after 2 and 4 days, respectively, associated with reductions of body weight and urine flow and with elevation of plasma renin activity, plasma sodium, and both plasma and urine osmolality. Dehydrated dogs drank copiously when allowed free access to water, and over the following 4 days both PGE2 excretion and plasma renin activity fell significantly, associated with elevation of body weight and urine volume and with lowering of plasma sodium and plasma and urine osmolality. In contrast, if after 4 days of water deprivation the dogs were kept at a constant level of dehydration by restricting their water allotment on subsequent days to 300 ml/day, PGE2 excretion and most other variables remained at the dehydration level. In conclusion, these results suggest that renal PGE2 production is dependent on the state of hydration in the dog.

scholarly journals Prevalence and Predictors of Malnutrition in Nasopharyngeal Carcinoma

2015 ◽  
Vol 8 ◽  
pp. CMENT.S12119 ◽  
Author(s):  
Catherine Wanjiru irungu ◽  
Herbert O. Oburra ◽  
Betha Ochola
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Nasopharyngeal Carcinoma ◽  
Serum Albumin ◽  
Stage Iv ◽  
Ideal Body Weight ◽  
Predictive Marker ◽  
Calorie Intake ◽  
Dietary History ◽  
Ideal Body

We assessed the prevalence and predictors of malnutrition in patients with nasopharyngeal carcinoma. Sixty cases and 123 controls matched for age and gender were included. Bio-data, dietary history, height, weight, body mass index (BMI), ideal body weight, and serum albumin levels were recorded. Pretreatment weight loss of >5% was present in 35% of subjects (P < 0.0001). A BMI of < 18.5 kg/m2 was present in 13.3% (P < 0.001), percent ideal body weight of <90% was present in 30% (P < 0.001), and serum albumin levels < 30 g/dL was present in 23.3% (P < 0.001) of cases. Nasopharyngeal carcinoma increased the likelihood of having a BMI < 18.5 kg/m2 (odds ratio, 9.3 (3.4–25.3) P ≤ 0.001). Logistic regression shows that stage IV disease was associated with a decrease in all parameters except protein-calorie intake. Stage IV nasopharyngeal carcinoma is a predictive marker for weight loss and low serum albumin levels. Nutritional management is important for ensuring the patients’ ability to withstand chemoradiation and thus improve survival and quality of life.

scholarly journals Untargeted fecal metabolome analysis in obese dogs after weight loss achieved by feeding a high-fiber-high-protein diet

Metabolomics ◽  
2021 ◽  
Vol 17 (7) ◽  
Author(s):  
Sandra Bermudez Sanchez ◽  
Rachel Pilla ◽  
Benjamin Sarawichitr ◽  
Alessandro Gramenzi ◽  
Fulvio Marsilio ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
High Protein Diet ◽  
Ideal Body Weight ◽  
Protein Diet ◽  
Metabolome Analysis ◽  
Functional Level ◽  
Fecal Microbiome ◽  
High Fiber ◽  
Ideal Body

Abstract Introduction In humans and companion animals, obesity is accompanied by metabolic derangements. Studies have revealed differences in the composition of the fecal microbiome between obese dogs and those with an ideal body weight. Objectives We have previously reported that the fecal microbiome in obese dogs changes after controlled weight reduction, induced by feeding a diet high in fiber and protein. Despite these findings, it is unclear if taxonomic differences infer differences at the functional level between obese dogs and those with an ideal body weight. Methodology Untargeted fecal metabolome analysis was performed on dogs with obesity before and after weight loss achieved by feeding a high-fiber-high-protein diet. Results Fecal metabolome analysis revealed a total of 13 compounds that changed in concentration in obese dogs after weight loss. Of these compounds, metabolites associated with bacterial metabolism decreased after weight loss including purine, L-(-)-methionine, coumestrol, and the alkaloids 1-methylxanthine and trigonelline. Conversely, the polyphenols (-)-epicatechin and matairesinol and the quinoline derivatives 1,5-isoquinolinediol and 2-hydroxiquinoline increased after weight loss. Conclusion These results suggest differences in intestinal microbiome at the functional level after weight loss, but further studies are needed to determine the role of these compounds in the etiology of obesity and weight loss.

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