Protein and Kidney Health
Protein and Kidney Health
By George Touliatos, MD
Q) Does protein affect kidney health?
A) Renal metabolism is a matter of hydration, sodium intake, systemic blood pressure and nitrogen balance, of course. Red meat tends to elevate serum creatinine. The reason is it’s high in creatine, metabolized to creatinine. However, if the kidneys are well hydrated and under normal blood pressure, 5 grams of creatine monohydrate is well tolerated. High BMI >30 will have an impact on creatinine. The reason is muscles are plentiful in creatine. That eventually will also be metabolized to creatinine. Moreover, under rupture muscles release myoglobin, the protein carrier of O2 to skeletal muscles. That can elevate creatinine under overtraining and rhabdomyolysis. Myoglobin is toxic to the renal glomerulus. More muscle tissue equals more creatine kinase (CK) elevation under training. This is why the glomerular filtration rate (GFR) formula doesn’t apply to bodybuilders; but to sedentary individuals with a casual physical activity schedule.
Serum creatinine and GFR are reversely related. Excessive animal protein intake along with dehydration can lead to azotemia, meaning elevated serum urea. In urea’s cycle, ammonia is a toxic byproduct. Occasionally there’s odor of NH3 (ammonia) in the sweat or the skin of bodybuilders who are under a diet and consume >3gr/kg of protein. This can give a lethargic, foggy mind – resembling the hepatic, comatose state. Drugs like NSAIDs and certain antibiotics can elevate creatinine. So do anabolic-androgenic steroids (AAS) that kick blood pressure and harden the renal glomerulus. Trenbolone is an example. Focal segmental glomerulosclerosis (FSGS) is the result of this. That leads to protein wasting, known as proteinuria. Normally, there are just protein traces in urine. Marathon running can cause proteinuria out of the thousands of steps that lead to concussion of kidneys. Under microscope assessment we can see cylinders, the epithelium of renal tubules.
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George Touliatos, MD is an author, lecturer, champion competitive bodybuilder and expert in medical prevention regarding PED use in sports. Dr. Touliatos specializes in medical biopathology and is the medical associate of Orthobiotiki.gr and Medihall.gr, Age Management and Preventive Clinics in Athens, Greece. Heis the author of four Greek books on bodybuilding, has extensively developed articles for www.anabolic.org and is the medical associate for the book “Anabolics, 11th Edition” (2017). Dr. Touliatos has been a columnist for the Greek editions of MuscleMag and Muscular Development magazines, and has participated in several seminars across Greece and Cyprus, making numerous TV and radio appearances, doing interviews in print and online. His personal website is https://gtoul.com/
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