Scientific Program (Oral Abstracts) | Poster Abstracts | Speaker List
SECOND INTERNATIONAL SYMPOSIUM
ON THE ROLE OF SOY
IN PREVENTING AND TREATING CHRONIC DISEASESeptember 15-18, 1996
Brussells, Belgium
SCIENTIFIC PROGRAM
(Oral Abstracts)Soy and Kidney Function
Soy Consumption and Renal Function In Patients with Nephrotic Syndrome: Clinical Effects and Potential Mechanism
M.G. Gentile, G. Manna*, G. D'Amico*.
Department of Clinical Nutrition and *Department of Nephrology, S.Carol Hospital, Milan, Italy.Renal function in individual without overt renal disease declines as a linear function with the time. The decline probably is related to the development of glomerulosclerosis. The presence of hypertension and of glomerular hyperfiltration may also affect the rate of decline the renal function. Experimental evidence also suggests that lipids may contribute directly to glomerular and tubulo-interstitial injury and that correction of lipid abnormalities associated with renal disease may slow the progression of chronic renal failure. Hyperlipidemia may exacerbate renal injury by a number of different mechanism (glomerular and tubulo interstitial lipoprotein deposition, mononuclear cell infiltration of mesangium, alterated cytokine production). Experimental studies suggest that particularly in nephrotic syndrome (NS) the accumulation of lipoproteins in mesangium may initiate a chronic inflammatory reaction with alteration in the glomerular filtration barrier and the resulting proteinuria.
The use of high animal protein and high fat diet is well known to worsen these processes. Soy protein diet, indeed, in subtotally nephrectomized rats proved to reduce proteinuria, renal histological damage, hyperlipidemia and glomerular hyperfiltration.
In order to evaluate if also in renal pts with NS, it is possible to reverse and/or slow down these processes, we recently tested a vegan soy diet on 40 nephrotic pts. Our diet was low in protein and fats (of which most were polyunsatured and monounsatured and free of cholesterol). We observed a significant reduction of urinary protein excretion (less 30%) and serum total and LDL cholesterol (respectively 28% and 33%). Urinary protein excretion showed a continuous fall during diet treatment and tended to return towards baseline values during washout period. To better understand the underlying mechanisms of reducing proteinuria we studied the red blood cell (RBC) membrane phosholipid (phl) contenent of 12 nephrotic pts on free diet and after vegan soy diet, (considering that the similar modification can happen in glomerular membrane altering glomerular filtration barrier and increasing glomerular membrane altering glomerular filtration barrier and increasing glomerular permselectivity). The RBC membrane phl was significant altered on free diet tend to approach the values of healthy control after treatment. We suggest that a vegan soy diet may have considerable benefit in pts with NS and that the reduction of serum cholesterol levels may contribute to the described renal protective effects.
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