Noninvasive Doppler assessment of human postprandial renal blood flow and cardiac output.

We compared the effects of protein, carbohydrate, or water ingestion on human renal blood flow (RBF) and cardiac output (CO). We validated and applied a noninvasive ultrasonic Doppler method to measure blood velocities and lumen diameters in the right renal artery and the ascending aorta of five healthy adults. From these measurements, we calculated the average RBF and CO over five cardiac cycles. Normalizing to body surface area, renal blood flow index to one kidney (RI) and cardiac index (CI) were calculated. The percentage of the CI distributed to a single kidney was determined as %CI = RI/CI. Subjects were studied randomly on three separate days after ingestion of each of the following equivolume (500 ml) meals: 1) 150 g protein, 30 g fat, and 30 g carbohydrate (P); 2) 150 g carbohydrate, 30 g fat, and 30 g protein (C); and 3) water. Data were obtained after 12 h of fasting and at 30, 60, 90, 120, 180, and 240 min postprandially. Analysis of covariance revealed significant (P less than 0.05) increases from fasting levels in postprandial RI at 90 to 240 min after P. Postprandial RI with P was significantly higher than with C at 180 and 240 min. Postprandial %CI with P and C decreased significantly from the fasting value at 30 to 180 min. Heart rate and mean arm cuff blood pressure did not change significantly with any diet. Results suggest that the protein-rich meal evokes a more sustained increase in postprandial RI than the carbohydrate rich meal. Despite the increase in postprandial RI, the percentage of cardiac output perfusing a kidney declines similarly with both diets.

RCT Entities:   Population Interventions Outcomes