Journal Article

Dietary protein intake does not affect IgG synthesis in patients with nephrotic syndrome

Mauro Giordano, Paola Lucidi, Pierpaolo De Feo, Emanuela dePascale, Tiziana Ciarambino and Pietro Castellino

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 19, issue 10, pages 2494-2498
Published in print October 2004 | ISSN: 0931-0509
Published online October 2004 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfh354
Dietary protein intake does not affect IgG synthesis in patients with nephrotic syndrome

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Background. Low plasma IgG levels have long been reported as an important complication of the nephrotic syndrome. Few studies in vivo have evaluated IgG synthesis in nephrotic patients and no data are available on the effect of dietary protein restriction on the rate of IgG synthesis.

Methods. We compared the IgG synthesis rates of seven nephrotic patients who assumed, for 4 weeks, either a normal protein diet (NPD) (1.20±0.06 g/kg/day) or a low-protein diet (LPD) (0.66±0.04 g/kg/day) with those of seven normal subjects (matched for age and body mass index). The post-absorptive fractional synthesis rate (FSR) and absolute synthesis rate (ASR) of IgG were evaluated during the last 120 min of a 5 h 5,5,5-D3-l-leucine infusion.

Results. Compared with controls, in nephrotic patients the plasma IgG levels and pool were significantly reduced (P<0.05), while IgG FSR and ASR were increased by 4- and 2.5-fold, respectively (P<0.05). The LPD regimen did not affect plasma IgG FSR, ASR, circulating concentrations and intravascular pool (P = NS). There was a significant negative correlation between plasma IgG FSR and the IgG intravascular pool in nephrotic patients evaluated during both the NPD (r = −0.828; P<0.05) and LPD (r = −0.861; P<0.05) regimens.

Conclusions. Nephrotic syndrome patients with low plasma IgG levels have increased IgG FSR and ASR which are not affected by reduced dietary protein intake.

Keywords: IgG metabolism; low protein diet; proteinuria

Journal Article.  3037 words.  Illustrated.

Subjects: Nephrology

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