Effect of daily energy expenditure on the creatinine clearance and daily urinary protein excretion of patients with mesangial proliferative glomerulonephritis.

Abstract

In the present study, the relationships among daily energy expenditure, renal function (creatinine clearance, Ccr), and daily urinary protein excretion were examined. In total, 104 adult patients (from 9 renal clinics in Japan) with primary chronic glomerulonephritis were fitted with a portable calorie counter for about two weeks to estimate their daily energy expenditure. On two separate days when the energy expenditure was expected to be contrastingly different, urine collection and blood sampling were performed, and the Ccr and daily urinary protein excretion were determined. Multiple regression analysis of Ccr clearly demonstrated a significant correlation between its acceleration and increase in the daily protein intake or protein excretion. In mesangial proliferative glomerulonephritis showing a constant level of protein intake, the enhancement of Ccr revealed a significant inverse relation to the increase in daily energy expenditure (%BMR). It was demonstrated statistically that a daily energy expenditure exceeding 150 %BMR slowed the Ccr down. This limit was almost the same as the level in healthy adults living in urban cities of Japan. The urinary protein excretion was significantly correlated with the daily protein intake. These results should be taken into consideration in prescribing for each individual patient an allowable degree of labor or any other activity and an adequate dietary regimen, and also in evaluating the efficacy of a drug for glomerulonephritis.