#18岁健身主播摄入蛋白质过量患肾病# 对于肾功能正常的健康人来说,目前没有充分证据表明高蛋白饮食(每天摄入量≥1.5g蛋白每kg体重)就会对肾功能带来不利的影响。[1]
对1135名肾功能正常的健康女性11年跟踪调查发现,高蛋白质摄入并不会导致肾功能受损。[2]
一次性大量吃蛋白质或者一段时间的高蛋白饮食可能会让肾小球滤过率 (glomerular filtration rate,GFR) 升高,这常常被认为是高蛋白饮食会影响肾功能的依据,但研究表明这种状态其实只是正常的响应和调节,GFR临时升高并不代表会导致肾病。
比如怀孕期间的健康女性GFR增加可高达65%,通常在产后三个月恢复到之前的水平,尽管怀孕期间会发生这样的变化,但妊娠并不是发生慢性肾病(chronic kidney disease,CKD)的危险因素。[3-5]
进行单侧肾切除的人,剩余的单肾也会通过提高GFR来适应,而对他们20年以上的跟踪随访表明,尽管长期高GFR,单肾功能仍保持正常。 [6-7]
运动员一般长期保持高蛋白质饮食,许多运动员的饮食习惯是超过每天2.0g蛋白/kg体重的,但没有证据表明该人群患肾病或肾功能丧失的风险更高。[8-9]
另外有研究发现,对采用高蛋白饮食来减肥的超重但健康的人来说,坚持6个月的高蛋白饮食没有对肾功能产生不利的影响。[10]
参考资料:
[1] Ko GJ, Obi Y, Tortorici AR, Kalantar-Zadeh K. Dietary protein intake and chronic kidney disease. Curr Opin Clin Nutr Metab Care. 2017;20(1):77-85.
[2] Knight EL, Stampfer MJ, Hankinson SE, Spiegelman D, Curhan GC:The Impact of Protein Intake on Renal Function Decline in Women with Normal Renal Function or Mild Renal Insufficiency. Ann Intern Med 2003, 138(6):460-467.
[3] Calderon JL, Zadshir A, Norris K: A survey of kidney disease and risk-factor information on the World Wide Web. MedGenMed 2004, 6(4):3.
[4] Lindheimer MD, Katz AI: Physiology and Pathophysiology . In Renal physiology and disease in pregnancy 2nd edition. Edited by: Seldin DW, Giebisch G. New York , Raven Press ; 1992:3371–3431.
[5] Conrad KP: Mechanisms of renal vasodilation and hyperfiltration during pregnancy. J Soc Gynecol Investig 2004, 11(7):438-448.
[6] Higashihara E, Horie S, Takeuchi T, Nutahara K, Aso Y: Long-term consequence of nephrectomy. J Urol 1990, 143(2):239-243.
[7] Regazzoni BM, Genton N, Pelet J, Drukker A, Guignard JP: Longterm followup of renal functional reserve capacity after unilateral nephrectomy in childhood. J Urol 1998, 160(3 Pt 1):844-848.
[8] Lemon PW: Is increased dietary protein necessary or beneficial for individuals with a physically active lifestyle? Nutr Rev 1996, 54(4 Pt 2):S169-75.
[9] Chen JD, Wang JF, Li KJ, Zhao YW, Wang SW, Jiao Y, Hou XY: Nutritional problems and measures in elite and amateur athletes. Am J Clin Nutr 1989, 49(5 Suppl):1084-1089.
[10] Skov AR, Toubro S, Bulow J, Krabbe K, Parving HH, Astrup A: Changes in renal function during weight loss induced by high vs low-protein low-fat diets in overweight subjects. Int J Obes Relat Metab Disord 1999, 23(11):1170-1177.
