Abstract
Increased protein intake versus maltodextrin intake for 4 weeks lowers blood pressure. Concerns exist that high‐protein diets reduce renal function. Effects of acute and 4‐week protein intake versus maltodextrin intake on renal acid load, glomerular filtration rate and related parameters were compared in this study. Seventy‐nine overweight individuals with untreated elevated blood pressure and normal kidney function were randomized to consume a mix of protein isolates (60 g/day) or maltodextrin (60 g/day) for 4 weeks in energy balance. Twenty‐four‐hour urinary potential renal acid load (uPRAL) was compared between groups. A subgroup (maltodextrin N = 27, protein mix N = 25) participated in extra test days investigating fasting levels and postprandial effects of meals supplemented with a moderate protein‐ or maltodextrin‐load on glomerular filtration rate, effective renal plasma flow, plasma renin, aldosterone, pH, and bicarbonate. uPRAL was significantly higher in the protein group after 4 weeks (P ≤ 0.001). Postprandial filtration fraction decreased further after the protein‐supplemented breakfast than after the maltodextrin‐supplemented breakfast after 4 weeks of supplementation (P ≤ 0.001). Fasting and postprandial levels of glomerular filtration rate, effective renal plasma flow, renin, aldosterone, angiotensin‐converting enzyme, pH and bicarbonate did not differ between groups. In conclusion, 4 weeks on an increased protein diet (25% of energy intake) increased renal acid load, but did not affect renal function. Postprandial changes, except for filtration fraction, also did not differ between groups. These data suggest that a moderate increase in protein intake by consumption of a protein mix for 4 weeks causes no (undesirable) effects on kidney function in overweight and obese individuals with normal kidney function.
Highlights
Increased protein diets are often advised to overweight and obese persons because these diets may reduce adiposity (Santesso et al 2012)
We investigated glomerular filtration rate (GFR) and acid load in response to a % 10% increase in energy intake from protein in overweight individuals with mild blood pressure elevation and normal kidney function
Chronic and postprandial responses of renal acid load, renal hemodynamics, renal function parameters, and the renin-angiotensin-aldosterone system were compared between protein- and maltodextrin-supplemented diets (Teunissen-Beekman et al 2012, 2013)
Summary
Increased protein diets are often advised to overweight and obese persons because these diets may reduce adiposity (Santesso et al 2012). A blood pressure lowering effect of 4 weeks of increased protein consumption (3 9 20 g/ day) compared with 4 weeks of maltodextrin consumption (3 9 20 g/day) in overweight individuals with mild blood pressure elevation was reported previously (Teunissen-Beekman et al 2012). We investigated GFR and acid load in response to a % 10% increase in energy intake from protein in overweight individuals with mild blood pressure elevation and normal kidney function. Chronic and postprandial responses of renal acid load, renal hemodynamics, renal function parameters, and the renin-angiotensin-aldosterone system were compared between protein- and maltodextrin-supplemented diets (Teunissen-Beekman et al 2012, 2013). Angiotensin-converting enzyme (ACE) activity was studied, because (milk)proteins are hypothesized to reduce blood pressure via ACE inhibition (McGregor and Poppitt 2013)
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