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The Effects of High-Protein Diets on Kidney Health and Longevity

Gang-Jee Ko, Connie M. Rhee, Kamyar Kalantar-Zadeh and Shivam Joshi
JASN August 2020, 31 (8) 1667-1679; DOI: https://doi.org/10.1681/ASN.2020010028
Gang-Jee Ko
1Harold Simmons Center for Kidney Disease Research and Epidemiology, School of Medicine, University of California Irvine, Orange, California
2Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Connie M. Rhee
1Harold Simmons Center for Kidney Disease Research and Epidemiology, School of Medicine, University of California Irvine, Orange, California
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Kamyar Kalantar-Zadeh
1Harold Simmons Center for Kidney Disease Research and Epidemiology, School of Medicine, University of California Irvine, Orange, California
3Department of Medicine, Long Beach Veteran Affairs Health System, Long Beach, California
4Los Angeles Biomedical Research Institute at Harbor–University of California, Los Angeles, Torrance, California
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Shivam Joshi
5Division of General Internal Medicine, Department of Medicine, New York University School of Medicine, New York, New York
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Abstract

Although high-protein diets continue to be popular for weight loss and type 2 diabetes, evidence suggests that worsening renal function may occur in individuals with—and perhaps without—impaired kidney function. High dietary protein intake can cause intraglomerular hypertension, which may result in kidney hyperfiltration, glomerular injury, and proteinuria. It is possible that long-term high protein intake may lead to de novo CKD. The quality of dietary protein may also play a role in kidney health. Compared with protein from plant sources, animal protein has been associated with an increased risk of ESKD in several observational studies, including the Singapore Chinese Health Study. Potential mediators of kidney damage from animal protein include dietary acid load, phosphate content, gut microbiome dysbiosis, and resultant inflammation. In light of such findings, adopting current dietary approaches that include a high proportion of protein for weight reduction or glycemic control should be considered with care in those at high risk for kidney disease. Given the possibility of residual confounding within some observational studies and the conflicting evidence from previous trials, long-term studies including those with large sample sizes are warranted to better ascertain the effects of high protein intake on kidney health.

  • nutrition
  • chronic kidney disease
  • high protein diet
  • glomerular hyperfiltration
  • proteinuria
  • Copyright © 2020 by the American Society of Nephrology
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Journal of the American Society of Nephrology: 31 (8)
Journal of the American Society of Nephrology
Vol. 31, Issue 8
August 2020
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The Effects of High-Protein Diets on Kidney Health and Longevity
Gang-Jee Ko, Connie M. Rhee, Kamyar Kalantar-Zadeh, Shivam Joshi
JASN Aug 2020, 31 (8) 1667-1679; DOI: 10.1681/ASN.2020010028

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The Effects of High-Protein Diets on Kidney Health and Longevity
Gang-Jee Ko, Connie M. Rhee, Kamyar Kalantar-Zadeh, Shivam Joshi
JASN Aug 2020, 31 (8) 1667-1679; DOI: 10.1681/ASN.2020010028
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  • Article
    • Abstract
    • The Rise in Popularity of High-Protein Diets
    • Proposed Pathways Linking High-Protein Diets and CKD
    • Harmful Metabolic Consequences of High-Protein Diets
    • Protein Source (Plant versus Animal Protein)
    • The Newest High-Protein Diet: the Ketogenic Diet
    • High-Protein Diets and Solitary Kidney
    • Future Directions
    • Conclusion
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  • glomerular hyperfiltration
  • proteinuria

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