Population-based dose-response curve of glomerular filtration rate to dietary protein intake

Massimo Cirillo, Fabiana Zingone, Cinzia Lombardi, Pierpaolo Cavallo, Alberto Zanchetti, Giancarlo Bilancio

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)1156-1162
Number of pages7
JournalNephrology Dialysis Transplantation
Volume30
Issue number7
DOIs
Publication statusPublished - Jul 1 2015

Fingerprint

Dietary Proteins
Glomerular Filtration Rate
Urea
Nitrogen
Population
Proteins
Creatinine
Up-Regulation
Kidney
Recommended Dietary Allowances
Sigmoid Colon
Serum
Weights and Measures
Mortality

Keywords

  • creatinine
  • dietary protein
  • eGFR
  • kidney function
  • urea

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Cirillo, M., Zingone, F., Lombardi, C., Cavallo, P., Zanchetti, A., & Bilancio, G. (2015). Population-based dose-response curve of glomerular filtration rate to dietary protein intake. Nephrology Dialysis Transplantation, 30(7), 1156-1162. https://doi.org/10.1093/ndt/gfv026

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 journalArticle

Cirillo, M, Zingone, F, Lombardi, C, Cavallo, P, Zanchetti, A & Bilancio, G 2015, 'Population-based dose-response curve of glomerular filtration rate to dietary protein intake', Nephrology Dialysis Transplantation, vol. 30, no. 7, pp. 1156-1162. https://doi.org/10.1093/ndt/gfv026
Cirillo, Massimo ; Zingone, Fabiana ; Lombardi, Cinzia ; Cavallo, Pierpaolo ; Zanchetti, Alberto ; Bilancio, Giancarlo. / Population-based dose-response curve of glomerular filtration rate to dietary protein intake. In: Nephrology Dialysis Transplantation. 2015 ; Vol. 30, No. 7. pp. 1156-1162.
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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).",
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AU - Cirillo, Massimo

AU - Zingone, Fabiana

AU - Lombardi, Cinzia

AU - Cavallo, Pierpaolo

AU - Zanchetti, Alberto

AU - Bilancio, Giancarlo

PY - 2015/7/1

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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).

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