Eric L. Knight, MD, MPH; Meir J. Stampfer, MD, DrPH; Susan E. Hankinson, RN, ScD; Donna Spiegelman, ScD; Gary C. Curhan, MD, ScD
Acknowledgments: The authors thank the participants of the Nurses' Health Study. They also thank Elaine Coughlan for carefully reviewing the statistical programming and manuscript content, Sue Malspeis for helping with the programming necessary to perform the measurement-error adjustment, Diane Feskanich for helping to interpret the food composition tables, Melissa Francis for assisting with manuscript preparation, and Walter Willett for reviewing the manuscript and making helpful suggestions.
Grant Support: By the National Institutes of Health (T32DK0740, T32DK07791, DK52866, CA87969, and HL34594).
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Eric L. Knight, MD, MPH, Channing Laboratory, Nurses' Health Study, 3rd Floor, 181 Longwood Avenue, Boston, MA 02115; e-mail, firstname.lastname@example.org.
Current Author Addresses: Drs. Knight, Hankinson, and Curhan: Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115.
Drs. Stampfer and Spiegelman: Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115.
Author Contributions: Conception and design: E.L. Knight, G.C. Curhan.
Analysis and interpretation of the data: E.L. Knight, M.J. Stampfer, S.E. Hankinson, D. Spiegelman, G.C. Curhan.
Drafting of the article: E.L. Knight, G.C. Curhan.
Critical revision of the article for important intellectual content: E.L. Knight, M.J. Stampfer, S.E. Hankinson, D. Spiegelman, G.C. Curhan.
Final approval of the article: E.L. Knight, M.J. Stampfer, S.E. Hankinson, D. Spiegelman, G.C. Curhan.
Provision of study materials or patients: G.C. Curhan.
Statistical expertise: E.L. Knight, M.J. Stampfer, D. Spiegelman, G.C. Curhan.
Obtaining of funding: G.C. Curhan.
Administrative, technical, or logistic support: E.L. Knight, M.J. Stampfer, S.E. Hankinson.
Collection and assembly of data: E.L. Knight, S.E. Hankinson, G.C. Curhan.
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;138:460-467. doi: 10.7326/0003-4819-138-6-200303180-00009
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Published: Ann Intern Med. 2003;138(6):460-467.
The potential effects of dietary protein consumption on renal function in persons with normal renal function or mild renal insufficiency have important public health implications given the prevalence of high-protein diets and protein supplementation (1-3). The American Heart Association's most recent revised guidelines suggest that a sustained high-protein diet may have adverse effects on renal function (4), but no data support this claim in people with normal renal function or mild renal insufficiency. However, there are theoretical reasons for such concern, including the fact that a high-protein diet may acutely increase the glomerular filtration rate (GFR) (5, 6) and possibly cause intraglomerular hypertension, which may lead to progressive loss of renal function (7).
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