Abstract
Background Kidney function measured as estimated glomerular filtration rate (eGFR) is a risk factor for mortality and severe diseases. Protein intake up-regulates kidney function. The dose-response curve of eGFR over protein intake is unknown. Urinary urea nitrogen is an objective index of protein intake. Methods The study cross-sectionally analysed the relation between overnight urinary urea nitrogen (onU-ureaN) and eGFR with and without control for other variables in 4106 adults of the Gubbio population. Analyses were done for serum creatinine (S-cr) also to investigate the independency of results from eGFR calculation. Results Higher onU-ureaN associated with higher eGFR, and lower S-cr independently of sex and age (simple and partial correlation coefficients >0.100, P <0.001). Analyses by onU-ureaN decile indicated sigmoid curves of eGFR and S-cr over onU-ureaN with trend to flatness in the lowest 20% and the highest 20% of onU-ureaN (10.12 mg/h, respectively). Multi-variable spline regression indicated that the relation of eGFR over onU-ureaN was non-significant for onU-ureaN onU-ureaN in the range 5.19-10.12 mg/h (coefficients = 1.35-1.64, lower 95% CI ≥ +0.48, P ≤ 0.002), and non-significant for onU-ureaN >10.12 mg/h (coefficient = +0.05, 95% CI = -0.06/ +0.16, P = 0.394). eGFR differed by ≈ 8 mL/min × 1.73 m2 between the lowest and highest 20% of onU-ureaN distribution. Conclusions Higher protein intake relates to higher eGFR. The relation is sigmoid with eGFR up-regulation for onU-ureaN >5.19 mg/h, a threshold approximately corresponding to the recommended daily allowance for protein intake (0.8 g/day per kg of ideal weight).
| Original language | English |
|---|---|
| Pages (from-to) | 1156-1162 |
| Number of pages | 7 |
| Journal | Nephrology Dialysis Transplantation |
| Volume | 30 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - Jul 1 2015 |
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Keywords
- creatinine
- dietary protein
- eGFR
- kidney function
- urea
ASJC Scopus subject areas
- Nephrology
- Transplantation
Cite this
Population-based dose-response curve of glomerular filtration rate to dietary protein intake. / Cirillo, Massimo; Zingone, Fabiana; Lombardi, Cinzia; Cavallo, Pierpaolo; Zanchetti, Alberto; Bilancio, Giancarlo.
In: Nephrology Dialysis Transplantation, Vol. 30, No. 7, 01.07.2015, p. 1156-1162.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Population-based dose-response curve of glomerular filtration rate to dietary protein intake
AU - Cirillo, Massimo
AU - Zingone, Fabiana
AU - Lombardi, Cinzia
AU - Cavallo, Pierpaolo
AU - Zanchetti, Alberto
AU - Bilancio, Giancarlo
PY - 2015/7/1
Y1 - 2015/7/1
N2 - Background Kidney function measured as estimated glomerular filtration rate (eGFR) is a risk factor for mortality and severe diseases. Protein intake up-regulates kidney function. The dose-response curve of eGFR over protein intake is unknown. Urinary urea nitrogen is an objective index of protein intake. Methods The study cross-sectionally analysed the relation between overnight urinary urea nitrogen (onU-ureaN) and eGFR with and without control for other variables in 4106 adults of the Gubbio population. Analyses were done for serum creatinine (S-cr) also to investigate the independency of results from eGFR calculation. Results Higher onU-ureaN associated with higher eGFR, and lower S-cr independently of sex and age (simple and partial correlation coefficients >0.100, P <0.001). Analyses by onU-ureaN decile indicated sigmoid curves of eGFR and S-cr over onU-ureaN with trend to flatness in the lowest 20% and the highest 20% of onU-ureaN (10.12 mg/h, respectively). Multi-variable spline regression indicated that the relation of eGFR over onU-ureaN was non-significant for onU-ureaN onU-ureaN in the range 5.19-10.12 mg/h (coefficients = 1.35-1.64, lower 95% CI ≥ +0.48, P ≤ 0.002), and non-significant for onU-ureaN >10.12 mg/h (coefficient = +0.05, 95% CI = -0.06/ +0.16, P = 0.394). eGFR differed by ≈ 8 mL/min × 1.73 m2 between the lowest and highest 20% of onU-ureaN distribution. Conclusions Higher protein intake relates to higher eGFR. The relation is sigmoid with eGFR up-regulation for onU-ureaN >5.19 mg/h, a threshold approximately corresponding to the recommended daily allowance for protein intake (0.8 g/day per kg of ideal weight).
AB - Background Kidney function measured as estimated glomerular filtration rate (eGFR) is a risk factor for mortality and severe diseases. Protein intake up-regulates kidney function. The dose-response curve of eGFR over protein intake is unknown. Urinary urea nitrogen is an objective index of protein intake. Methods The study cross-sectionally analysed the relation between overnight urinary urea nitrogen (onU-ureaN) and eGFR with and without control for other variables in 4106 adults of the Gubbio population. Analyses were done for serum creatinine (S-cr) also to investigate the independency of results from eGFR calculation. Results Higher onU-ureaN associated with higher eGFR, and lower S-cr independently of sex and age (simple and partial correlation coefficients >0.100, P <0.001). Analyses by onU-ureaN decile indicated sigmoid curves of eGFR and S-cr over onU-ureaN with trend to flatness in the lowest 20% and the highest 20% of onU-ureaN (10.12 mg/h, respectively). Multi-variable spline regression indicated that the relation of eGFR over onU-ureaN was non-significant for onU-ureaN onU-ureaN in the range 5.19-10.12 mg/h (coefficients = 1.35-1.64, lower 95% CI ≥ +0.48, P ≤ 0.002), and non-significant for onU-ureaN >10.12 mg/h (coefficient = +0.05, 95% CI = -0.06/ +0.16, P = 0.394). eGFR differed by ≈ 8 mL/min × 1.73 m2 between the lowest and highest 20% of onU-ureaN distribution. Conclusions Higher protein intake relates to higher eGFR. The relation is sigmoid with eGFR up-regulation for onU-ureaN >5.19 mg/h, a threshold approximately corresponding to the recommended daily allowance for protein intake (0.8 g/day per kg of ideal weight).
KW - creatinine
KW - dietary protein
KW - eGFR
KW - kidney function
KW - urea
UR - http://www.scopus.com/inward/record.url?scp=84936792123&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84936792123&partnerID=8YFLogxK
U2 - 10.1093/ndt/gfv026
DO - 10.1093/ndt/gfv026
M3 - Article
C2 - 25805215
AN - SCOPUS:84936792123
VL - 30
SP - 1156
EP - 1162
JO - Nephrology Dialysis Transplantation
JF - Nephrology Dialysis Transplantation
SN - 0931-0509
IS - 7
ER -