Revisiting glomerular hyperfiltration and examining the concept of high dietary protein-related nephropathy in athletes and bodybuilders
- 주제(키워드) anabolic steroid nephropathy , glomerular hyperfiltration , high protein-induced nephropathy , kidney health
- 주제(기타) Urology & Nephrology
- 주제(기타) Peripheral Vascular Disease
- 설명문(일반) [Cho, Eunjung; Ko, Gang-Jee] Korea Univ, Dept Internal Med, Coll Med, Seoul, South Korea; [Choi, Soo Jeong] Soonchunhyang Univ, Dept Internal Med, Div Nephrol, Coll Med, Bucheon, Gyeonggi Do, South Korea; [Kang, Duk-Hee] Ewha Womans Univ, Dept Internal Med, Div Nephrol, Coll Med, Seoul, South Korea; [Kalantar-Zadeh, Kamyar] Univ Calif Irvine, Harold Simmons Ctr Kidney Dis Res & Epidemiol, Sch Med, Orange, CA USA; [Kalantar-Zadeh, Kamyar] Long Beach Vet Affairs Hlth Syst, Dept Med, Long Beach, CA USA; [Kalantar-Zadeh, Kamyar] Harbor UCLA, Los Angeles Biomed Res Inst, Torrance, CA USA
- 등재 SCIE, SCOPUS
- OA유형 Green Published
- 발행기관 LIPPINCOTT WILLIAMS & WILKINS
- 발행년도 2022
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000190853
- 본문언어 영어
- Published As https://doi.org/10.1097/MNH.0000000000000755
- PubMed https://pubmed.ncbi.nlm.nih.gov/34846311
초록/요약
Purpose of review High-protein diets (HPDs) are popular but their consequences for kidney health, especially among athletes and bodybuilders who typically maintain a high protein intake for a long time, have not been investigated. This review focused on recent studies of the association of HPD with long-term kidney health and the concept of high dietary protein-related nephropathy. Recent findings Several long-term observational studies including large populations have reinforced the notion that HPDs are associated with a rapid decline of kidney function. An increase in renal blood flow and glomerular hyperfiltration caused by vasodilation, and increased levels of endocrine and paracrine factors (glucagon, IGF-1, prostanoids, and nitric oxide), facilitates the excretion of protein-derived nitrogenous waste. Inhibition of tubule-glomerular feedback and increased proximal tubular Na+ reabsorption after a HPD augment glomerular hyperfiltration and may trigger synthesis of proinflammatory cytokines and receptor for advanced glycation end-products (RAGE). Focal segmental glomerulosclerosis reported in association with anabolic steroid may indeed be a HPD nephropathy given that HPD results in progressive glomerulosclerosis, especially in remnant glomeruli or in diabetic kidney disease but can happen in any high-risk situation, such as solitary kidney and polycystic kidneys. HPD among athletes and bodybuilders in an extreme way across a long-term period may pose a risk to renal health including high incidence of HPD nephropathy.
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