Protein/Creatine and Renal Function

Discussion in 'Diet & Nutrition' started by dkm1987, Feb 10, 2006.

  1. dkm1987

    dkm1987 New Member

    Ok, it was noted in another thread that high protein ingestion and also long term creatine ingestion may, let me stress may, cause renal system dysfunction. Now that I have a minute to address this let me say. The reason I am even posting this is I do not want anyone to get the assumption, from a few isolated case reports of renal dysfunction, that increased Protein or Creatine ingestion in and of itself is harmful when this isn't the case at all.

    But anyone concerned with this matter should seek their Doctor's advice.

    Protein-In a healthy population there is little conclusive evidence to support this. Proteinuria isn't absolutely identified yet as a cause of or simply a consequence of CKD. Most research sugesting reducing protein intake isn't based on healthy populations and those with normal filtration aren't affected by higher protein ingestion.

    Raila J, Forterre S, Schweigert FJ.
    [Physiologic and pathophysiologic fundamentals of proteinuria--a review]
    Berl Munch Tierarztl Wochenschr. 2005 May-Jun;118(5-6):229-39. Review. German.

    Mitch WE.
    Beneficial responses to modified diets in treating patients with chronic kidney disease.
    Kidney Int Suppl. 2005 Apr;(94):S133-5. Review.

    Kent PS.
    Integrating clinical nutrition practice guidelines in chronic kidney disease.
    Nutr Clin Pract. 2005 Apr;20(2):213-7. Review.

    Friedman AN.
    High-protein diets: potential effects on the kidney in renal health and disease.
    Am J Kidney Dis. 2004 Dec;44(6):950-62. Review.

    Zandi-Nejad K, Eddy AA, Glassock RJ, Brenner BM.
    Why is proteinuria an ominous biomarker of progressive kidney disease?
    Kidney Int Suppl. 2004 Nov;(92):S76-89. Review.

    Creatine-Pretty much the same, in a healthy person the risk associated with chronic creatine consumption has not been shown to cause much risk at all.

    Pline KA, Smith CL.
    The effect of creatine intake on renal function.
    Ann Pharmacother. 2005 Jun;39(6):1093-6. Epub 2005 May 10. Review.

    Yoshizumi WM, Tsourounis C.
    Effects of creatine supplementation on renal function.
    J Herb Pharmacother. 2004;4(1):1-7. Review.

    Poortmans JR, Francaux M.
    Adverse effects of creatine supplementation: fact or fiction?
    Sports Med. 2000 Sep;30(3):155-70. Review.

    Taes YE, Delanghe JR, Wuyts B, van de Voorde J, Lameire NH.
    Creatine supplementation does not affect kidney function in an animal model with pre-existing renal failure.
    Nephrol Dial Transplant. 2003 Feb;18(2):258-64.

    Robinson TM, Sewell DA, Casey A, Steenge G, Greenhaff PL.
    Dietary creatine supplementation does not affect some haematological indices, or indices of muscle damage and hepatic and renal function.
    Br J Sports Med. 2000 Aug;34(4):284-8.

    Farquhar WB, Zambraski EJ.
    Effects of creatine use on the athlete's kidney.
    Curr Sports Med Rep. 2002 Apr;1(2):103-6. Review.
     
  2. Aaron_F

    Aaron_F New Member

    Also note that the prevalence of decreased kidney function in the USA is approximate 1 in 10, and increasing.

    THat and the high protein diets and renal function work is around 1.5g per kilogram and less, which is a bit different to 2.2g/kg (1g/lb) that bbrs usually start at, and go upward sfrom (some are 4-5g/kilo...)

    At ~1.5g/kg there is an increase in GFR but not much else appears, at least in a 6mth period.

    in terms of creatine and renal function its actually been looked at in 'normal use' better than high protein diets for some reason. But there still hasnt been a really long term study, but that can be said about a lot of things. In the short term there is no apparent effect.
     
  3. dkm1987

    dkm1987 New Member

    Even some work as high as 2.6g/Kg showed no ill effect in chronic ingestion.

    Agreed, as I posted in the other thread this also depends, not only on amount, but also type.
     
  4. Aaron_F

    Aaron_F New Member

    Note this paper, one of the better controlled papers on high protein and weight loss, but they also looked at kidney function over a relativelhy long time. This is not high protein by our standards, but it is from 'research' perspectives

    Changes in renal function during weight loss induced by high vs low-protein low-fat diets in overweight subjects.

    Skov AR, Toubro S, Bulow J, Krabbe K, Parving HH, Astrup A.

    Research Department of Human Nutrition, The Royal Veterinary and Agricultural University, Copenhagen, Denmark.

    BACKGROUND: Due to the high satiating effect of protein, a high-protein diet may be desirable in the treatment of obesity. However the long-term effect of different levels of protein intake on renal function is unclear. OBJECTIVE: To assess the renal effects of high vs low protein contents in fat-reduced diets. DESIGN: Randomized 6 months dietary intervention study comparing two controlled ad libitum diets with 30 energy (E%) fat content: high-protein (HP; 25 E%) or low-protein, (LP, 12 E% protein). All food was provided by self-selection in a shop at the department, and high compliance to the diet composition was confirmed by measurements of urinary nitrogen excretion. SUBJECTS: 65 healthy, overweight and obese (25<body mass index (BMI)<34 kg/m2). RESULTS: Dietary protein intake changed from 91.1 g/d to a 6 months intervention average of 70.4 g/d (P<0.05) in the LP group and from 91.4 g/d to 107.8 g/d (P<0.05) in the HP group, producing changes in glomerular filtration rate (GFR) of -7.1 ml/min in the LP group and +5. 2 ml/min in the HP group (group effect: P<0.05). Kidney volume decreased by -6.2 cm3 in the LP group and increased by +9.1 cm3 in the HP group (P<0.05), whereas albuminuria remained unchanged in all groups. CONCLUSION: Moderate changes in dietary protein intake cause adaptive alterations in renal size and function without indications of adverse effects.
     
  5. dkm1987

    dkm1987 New Member

  6. Aaron_F

    Aaron_F New Member

    2.6g/kg where? or are you talking about some of the short term weight training trials?
     
  7. dkm1987

    dkm1987 New Member

    When I get a chance I'll dig it up again and shot it to you.
     
  8. Aaron_F

    Aaron_F New Member

    its not the old one from EJCN? or one of peter lemons?
     
  9. dkm1987

    dkm1987 New Member

    Yup the ole EJCN-Brandle
    the other was Poortmans JR. 2000, 7 day test so it didn't look at chronic, sorry [​IMG]
     

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