This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The incidences of obesity and chronic kidney disease are increasing at alarming rates. The concomitant rise may be coincidental, but data exist that link obesity to two distinct and reversible alterations in kidney function -- glomerular hyperfiltration and increased albuminuria -- that may promote kidney disease. However, available studies do not clearly distinguish between the effects and interactions of obesity and dietary protein intake in the pathogenesis of these changes. Therefore, we propose to test the hypothesis that obesity leads to reversible increases in the glomerular filtration rate and albuminuria that are independent of, and enhanced by, high dietary protein intake. An interventional, controlled dietary study will be conducted in morbidly obese humans that will measure the effects of differing protein diets and weight loss on these parameters. Results from this project will help in understanding the impact of the obesity pandemic on chronic kidney disease. It will also provide important preliminary data for future studies in this area, and will help determine whether popular high-protein diets aggravate an injurious effects of obesity on the kidney. To help prepare him to become an independent clinical investigator, Dr. Friedman has recently applied for an NIH K23 grant. In addition, Dr. Friedman has assembled a distinguished team of leading investigators in the fields of nutrition, kidney function, obesity and adipocyte biology to advise and mentor him. Furthermore, Dr. Friedman has optimized the design of this project by characterizing the morbidly obese population undergoing surgical weight reduction and their post-operative nutritional intake and weight changes.
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