Original Investigations: Pathogenesis and Treatment of Kidney Disease and HypertensionEffect of low-carbohydrate high-protein diets on acid-base balance, stone-forming propensity, and calcium metabolism☆,☆☆,★
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Experimental subjects
Subjects were recruited by advertisement. Included in the study were men and women with a body mass index (BMI) of 22 kg/m2 or greater and a desire to lose weight. Exclusion criteria were the presence or history of peptic ulcer disease, intestinal strictures, chronic diarrhea, renal calculi, metabolic acidosis or alkalosis, osteoporosis, gout, hyperuricemia, hyperkalemia, hypokalemia, arrhythmias, hypercalcemia, decreased endogenous creatinine clearance (≤0.6 mL/min/kg [0.0167 mL/s/kg]), and
Baseline demography
Eighty volunteers were screened for the study. Ten healthy subjects (seven women, three men; age, 21 to 52 years; mean, 38.4 years) participated in the study. Three subjects were Latin American, and seven subjects were white. At entry, subjects had a mean height of 166 cm (range, 152 to 189 cm), mean weight of 81.4 kg (range, 56.7 to 109.9 kg), and mean BMI of 29.4 kg/cm2 (range, 22.0 to 38.3 kg/cm2).
Composition of metabolic diets
The composition of each subject's three different metabolic diets was estimated by using US
Discussion
The objective of this study is to examine the effects of LCHP weight-reducing diets on acid-base balance, stone-forming propensity, and calcium metabolism in healthy individuals. Our data show that such a diet provides an exaggerated acid load, increasing risks for renal calculi formation and bone loss.
The increased acid load delivered by an LCHP diet was reflected in the increased urinary titratable acidity and urinary ammonium excretion. These diets were associated with a striking increase in
Acknowledgements
No grant support was obtained by any industry. None of the authors have a proprietary interest in any diet evaluated. The authors thank Beverley Adams-Huet, John Poindexter, Faye Britton, William Gitomer, Carolyn Griffith, Alan Stewart, Robert Butsch, and Rebecca Aricheta for assistance during this project.
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Supported in part by grants no. P01-DK20543 and M01-RR00633USPHS from the US Public Health Service.
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Address reprint requests to Shalini T. Reddy, MD, The University of Chicago, Department of Medicine, Section of General Internal Medicine, 5841 S Maryland Ave, MC 3051, Chicago, IL 60637. E-mail: [email protected]
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