The impact of habitually consuming a high protein (HP) diet at the upper limit of the acceptable macronutrient distribution range (AMDR) on kidney health is unknown. The current study was designed to test the hypothesis that long-term consumption of a diet providing 35% of energy as protein will have negative consequences on renal health, as assessed in a pig model. Methods: Adult female, non-pregnant, commercial pigs (Genesus) were randomized to receive either NP (15% energy from protein) or HP (35% energy from protein) isocaloric diets for either 4 or 8 months. Diets contained whole protein sources with an animal: plant ratio of 2:1 in the NP diet to mimic the average Canadian diet. The increased protein in the HP diet was achieved by increasing egg and dairy protein sources. Body composition was measured by dual-energy X-ray absorptiometry. Glomerular volume and kidney fibrosis were evaluated on kidney sections by quantitative image analysis. The inflammatory marker monocyte chemoattractant protein-1 (MCP-1) and the growth factor transforming growth factor beta-1(TGFβ1) were assessed in renal tissue using commercial ELISA kits. Results: Pigs given the HP diet had lower body weights and percentage of body fat. Pigs consuming the HP diet had significantly higher glomerular filtration rates (GFR) and larger kidneys. Renal MCP-1 levels and renal fibrosis also were significantly higher in pigs given the HP diet, while proteinuria and renal TGFβ1 expression did not differ. Conclusion: These findings suggest that, despite the potential benefit of the HP diet on body composition, long-term intakes of protein at the upper limit of the AMDR may compromise renal health in healthy female pigs. / October 2008

The impact of habitually consuming a high protein (HP) diet at the upper limit of the acceptable macronutrient distribution range (AMDR) on kidney health is unknown. The current study was designed to test the hypothesis that long-term consumption of a diet providing 35% of energy as protein will have negative consequences on renal health, as assessed in a pig model. Methods: Adult female, non-pregnant, commercial pigs (Genesus) were randomized to receive either NP (15% energy from protein) or HP (35% energy from protein) isocaloric diets for either 4 or 8 months. Diets contained whole protein sources with an animal: plant ratio of 2:1 in the NP diet to mimic the average Canadian diet. The increased protein in the HP diet was achieved by increasing egg and dairy protein sources. Body composition was measured by dual-energy X-ray absorptiometry. Glomerular volume and kidney fibrosis were evaluated on kidney sections by quantitative image analysis. The inflammatory marker monocyte chemoattractant protein-1 (MCP-1) and the growth factor transforming growth factor beta-1(TGFβ1) were assessed in renal tissue using commercial ELISA kits. Results: Pigs given the HP diet had lower body weights and percentage of body fat. Pigs consuming the HP diet had significantly higher glomerular filtration rates (GFR) and larger kidneys. Renal MCP-1 levels and renal fibrosis also were significantly higher in pigs given the HP diet, while proteinuria and renal TGFβ1 expression did not differ. Conclusion: These findings suggest that, despite the potential benefit of the HP diet on body composition, long-term intakes of protein at the upper limit of the AMDR may compromise renal health in healthy female pigs.

The impact of habitually consuming a high protein (HP) diet at the upper limit of the acceptable macronutrient distribution range (AMDR) on kidney health is unknown. The current study was designed to test the hypothesis that long-term consumption of a diet providing 35% of energy as protein will have negative consequences on renal health, as assessed in a pig model. Methods: Adult female, non-pregnant, commercial pigs (Genesus) were randomized to receive either NP (15% energy from protein) or HP (35% energy from protein) isocaloric diets for either 4 or 8 months. Diets contained whole protein sources with an animal: plant ratio of 2:1 in the NP diet to mimic the average Canadian diet. The increased protein in the HP diet was achieved by increasing egg and dairy protein sources. Body composition was measured by dual-energy X-ray absorptiometry. Glomerular volume and kidney fibrosis were evaluated on kidney sections by quantitative image analysis. The inflammatory marker monocyte chemoattractant protein-1 (MCP-1) and the growth factor transforming growth factor beta-1(TGFβ1) were assessed in renal tissue using commercial ELISA kits. Results: Pigs given the HP diet had lower body weights and percentage of body fat. Pigs consuming the HP diet had significantly higher glomerular filtration rates (GFR) and larger kidneys. Renal MCP-1 levels and renal fibrosis also were significantly higher in pigs given the HP diet, while proteinuria and renal TGFβ1 expression did not differ. Conclusion: These findings suggest that, despite the potential benefit of the HP diet on body composition, long-term intakes of protein at the upper limit of the AMDR may compromise renal health in healthy female pigs.

A inicios del año 2020, se registraron 4,300 asegurados a EsSalud diagnosticados con Enfermedad Renal Crónica Terminal (ERCT) en el departamento de Lima, quienes han venido recibiendo sesiones de hemodiálisis en el Centro Nacional de Salud Renal (CNSR) y clínicas contratadas para este servicio, según lo reportado por la IAFAS antes mencionada. Por parte de los asegurados al SIS, el Fondo Intangible Solidario en Salud (FISSAL) informó que a inicios del 2020 que 6 mil 268 asegurados vienen recibiendo hemodiálisis en centros particulares de salud de Lima Metropolitana y las diferentes regiones del país. El presente proyecto plantea brindar el servicio ambulatorio de hemodiálisis a pacientes con Enfermedad Renal Crónica Terminal afiliados a la IAFAS EsSalud, puesto que tiene una sobredemanda que requieren del servicio de Hemodiálisis, y que actualmente no se encuentra cubierta ni por la oferta propia ni por la subcontratada con otros centros de hemodiálisis.  Nuestra estrategia es de “Liderazgo en costos”, con una propuesta de valor basada en atención personalizada con un equipo multidisciplinario, altos estándares de calidad y un modelo de gestión centrado en el paciente, según los Términos de Referencia (TDR) requeridos por EsSalud. Desde el punto de vista financiero, la inversión total del proyecto es de S/. 447,110.00 presentando un VAN de S/. 2,676,707.15 y un TIR es 86.1%. Los principales riesgos del proyecto son los financieros y económicos, como la falta de liquidez y lograr la contratación por la IAFAS EsSalud. / At the beginning of 2020, 4,300 insured persons were registered with EsSalud diagnosed with Terminal Chronic Kidney Disease (ESRD) in the department of Lima, who have been receiving hemodialysis sessions at the National Renal Health Center (CNSR) and clinics hired for this service, as reported by the aforementioned IAFAS. On the part of those insured to the SIS, the Intangible Solidarity in Health Fund (FISSAL) reported that at the beginning of 2020, 6,268 insured have been receiving hemodialysis in private health centers in Metropolitan Lima and the different regions of the country. This project proposes to provide the outpatient hemodialysis service to patients with Terminal Chronic Kidney Disease affiliated to IAFAS EsSalud, since it has an over-demand for them that require the Hemodialysis service, and which is currently not covered even by its own offer nor by the one subcontracted to other hemodialysis centers. Our strategy is “Cost Leadership”, with a value proposition based on personalized attention with a multidisciplinary team, high quality standards and a patient-centered management model, according to the Terms of Reference (TOR) required by EsSalud. From a financial point of view, the total investment of the project is S /. 447,110.00 presenting a NPV of S /. 2,676,707.15 and an IRR is 86.1%. The main risks of the project are financial and economic, such as lack of liquidity and being hired by IAFAS EsSalud / Trabajo de investigación