Effects of Low-Protein, and Supplemented Very Low–Protein Diets, on Muscle Protein Turnover in Patients With CKD
Introduction: Early studies have shown that patients with chronic kidney disease (CKD) are able to maintain nitrogen balance despite significantly lower protein intake, but how and to what extent muscle protein metabolism adapts to a low-protein diet (LPD) or to a supplemented very LPD (sVLPD) is st...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2018-05-01
|
| Series: | Kidney International Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S246802491830010X |
| _version_ | 1818540534910681088 |
|---|---|
| author | Giacomo Garibotto Antonella Sofia Emanuele Luigi Parodi Francesca Ansaldo Alice Bonanni Daniela Picciotto Alessio Signori Monica Vettore Paolo Tessari Daniela Verzola |
| author_facet | Giacomo Garibotto Antonella Sofia Emanuele Luigi Parodi Francesca Ansaldo Alice Bonanni Daniela Picciotto Alessio Signori Monica Vettore Paolo Tessari Daniela Verzola |
| author_sort | Giacomo Garibotto |
| collection | DOAJ |
| description | Introduction: Early studies have shown that patients with chronic kidney disease (CKD) are able to maintain nitrogen balance despite significantly lower protein intake, but how and to what extent muscle protein metabolism adapts to a low-protein diet (LPD) or to a supplemented very LPD (sVLPD) is still unexplored. Methods: We studied muscle protein turnover by the forearm perfusion method associated with the kinetics of 2H-phenylalanine in patients with CKD: (i) in a parallel study in subjects randomized to usual diet (1.1 g protein/kg, n = 5) or LPD (0.55 g protein/kg, n = 6) (Protocol 1); (ii) in a crossover, self-controlled study in subjects on a 0.55 g/kg LPD followed by a sVLPD (0.45 g/kg + amino/ketoacids 0.1 g/kg, n = 6) (Protocol 2). Results: As compared with a 1.1 g/kg containing diet, a 0.55 g/kg LPD induced the following: (i) a 17% to 40% decrease in muscle protein degradation and net protein balance, respectively, (ii) no change in muscle protein synthesis, (iii) a slight (by approximately 7%, P < 0.06) decrease in whole-body protein degradation, and (iv) an increase in the efficiency of muscle protein turnover. As compared with an LPD, an sVLPD induced the following: (i) no change in muscle protein degradation, and (ii) an approximately 50% decrease in the negative net protein balance, and an increase in the efficiency of muscle protein turnover. Conclusion: The results of these studies indicate that in patients with CKD the adaptation of muscle protein metabolism to restrained protein intake can be obtained via combined responses of protein degradation and the efficiency of recycling of amino acids deriving from protein breakdown. Keywords: amino acids, chronic kidney disease, ketoacids, low-protein diet, nutrition |
| first_indexed | 2024-12-11T21:56:39Z |
| format | Article |
| id | doaj.art-84e47db431284221a4ca6fb51f5cd675 |
| institution | Directory Open Access Journal |
| issn | 2468-0249 |
| language | English |
| last_indexed | 2024-12-11T21:56:39Z |
| publishDate | 2018-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj.art-84e47db431284221a4ca6fb51f5cd6752022-12-22T00:49:16ZengElsevierKidney International Reports2468-02492018-05-0133701710Effects of Low-Protein, and Supplemented Very Low–Protein Diets, on Muscle Protein Turnover in Patients With CKDGiacomo Garibotto0Antonella Sofia1Emanuele Luigi Parodi2Francesca Ansaldo3Alice Bonanni4Daniela Picciotto5Alessio Signori6Monica Vettore7Paolo Tessari8Daniela Verzola9Division of Nephrology, Dialysis and Transplantation, Department of Internal Medicine, University of Genoa and Ospedale Policlinico San Martino, Genoa, Italy; Correspondence: Giacomo Garibotto, Department of Internal Medicine, Division of Nephrology, Dialysis and Transplantation, Università di Genova, Viale Benedetto XV, 6, 16132 Genoa, Italy.Division of Nephrology, Dialysis and Transplantation, Department of Internal Medicine, University of Genoa and Ospedale Policlinico San Martino, Genoa, ItalyDivision of Nephrology, Dialysis and Transplantation, Department of Internal Medicine, University of Genoa and Ospedale Policlinico San Martino, Genoa, ItalyDivision of Nephrology, Dialysis and Transplantation, Department of Internal Medicine, University of Genoa and Ospedale Policlinico San Martino, Genoa, ItalyDivision of Nephrology, Dialysis and Transplantation, Department of Internal Medicine, University of Genoa and Ospedale Policlinico San Martino, Genoa, ItalyDivision of Nephrology, Dialysis and Transplantation, Department of Internal Medicine, University of Genoa and Ospedale Policlinico San Martino, Genoa, ItalyDepartment of Health Sciences, Biostatistics Unit, University of Genoa, Genoa, ItalyMetabolism Division, Department of Medicine, University of Padova, ItalyMetabolism Division, Department of Medicine, University of Padova, ItalyDivision of Nephrology, Dialysis and Transplantation, Department of Internal Medicine, University of Genoa and Ospedale Policlinico San Martino, Genoa, ItalyIntroduction: Early studies have shown that patients with chronic kidney disease (CKD) are able to maintain nitrogen balance despite significantly lower protein intake, but how and to what extent muscle protein metabolism adapts to a low-protein diet (LPD) or to a supplemented very LPD (sVLPD) is still unexplored. Methods: We studied muscle protein turnover by the forearm perfusion method associated with the kinetics of 2H-phenylalanine in patients with CKD: (i) in a parallel study in subjects randomized to usual diet (1.1 g protein/kg, n = 5) or LPD (0.55 g protein/kg, n = 6) (Protocol 1); (ii) in a crossover, self-controlled study in subjects on a 0.55 g/kg LPD followed by a sVLPD (0.45 g/kg + amino/ketoacids 0.1 g/kg, n = 6) (Protocol 2). Results: As compared with a 1.1 g/kg containing diet, a 0.55 g/kg LPD induced the following: (i) a 17% to 40% decrease in muscle protein degradation and net protein balance, respectively, (ii) no change in muscle protein synthesis, (iii) a slight (by approximately 7%, P < 0.06) decrease in whole-body protein degradation, and (iv) an increase in the efficiency of muscle protein turnover. As compared with an LPD, an sVLPD induced the following: (i) no change in muscle protein degradation, and (ii) an approximately 50% decrease in the negative net protein balance, and an increase in the efficiency of muscle protein turnover. Conclusion: The results of these studies indicate that in patients with CKD the adaptation of muscle protein metabolism to restrained protein intake can be obtained via combined responses of protein degradation and the efficiency of recycling of amino acids deriving from protein breakdown. Keywords: amino acids, chronic kidney disease, ketoacids, low-protein diet, nutritionhttp://www.sciencedirect.com/science/article/pii/S246802491830010X |
| spellingShingle | Giacomo Garibotto Antonella Sofia Emanuele Luigi Parodi Francesca Ansaldo Alice Bonanni Daniela Picciotto Alessio Signori Monica Vettore Paolo Tessari Daniela Verzola Effects of Low-Protein, and Supplemented Very Low–Protein Diets, on Muscle Protein Turnover in Patients With CKD Kidney International Reports |
| title | Effects of Low-Protein, and Supplemented Very Low–Protein Diets, on Muscle Protein Turnover in Patients With CKD |
| title_full | Effects of Low-Protein, and Supplemented Very Low–Protein Diets, on Muscle Protein Turnover in Patients With CKD |
| title_fullStr | Effects of Low-Protein, and Supplemented Very Low–Protein Diets, on Muscle Protein Turnover in Patients With CKD |
| title_full_unstemmed | Effects of Low-Protein, and Supplemented Very Low–Protein Diets, on Muscle Protein Turnover in Patients With CKD |
| title_short | Effects of Low-Protein, and Supplemented Very Low–Protein Diets, on Muscle Protein Turnover in Patients With CKD |
| title_sort | effects of low protein and supplemented very low protein diets on muscle protein turnover in patients with ckd |
| url | http://www.sciencedirect.com/science/article/pii/S246802491830010X |
| work_keys_str_mv | AT giacomogaribotto effectsoflowproteinandsupplementedverylowproteindietsonmuscleproteinturnoverinpatientswithckd AT antonellasofia effectsoflowproteinandsupplementedverylowproteindietsonmuscleproteinturnoverinpatientswithckd AT emanueleluigiparodi effectsoflowproteinandsupplementedverylowproteindietsonmuscleproteinturnoverinpatientswithckd AT francescaansaldo effectsoflowproteinandsupplementedverylowproteindietsonmuscleproteinturnoverinpatientswithckd AT alicebonanni effectsoflowproteinandsupplementedverylowproteindietsonmuscleproteinturnoverinpatientswithckd AT danielapicciotto effectsoflowproteinandsupplementedverylowproteindietsonmuscleproteinturnoverinpatientswithckd AT alessiosignori effectsoflowproteinandsupplementedverylowproteindietsonmuscleproteinturnoverinpatientswithckd AT monicavettore effectsoflowproteinandsupplementedverylowproteindietsonmuscleproteinturnoverinpatientswithckd AT paolotessari effectsoflowproteinandsupplementedverylowproteindietsonmuscleproteinturnoverinpatientswithckd AT danielaverzola effectsoflowproteinandsupplementedverylowproteindietsonmuscleproteinturnoverinpatientswithckd |