Interacción entre ejercicio, dieta hiperproteica, suplementos y AINEs: efectos en la función renal
Contenido principal del artículo
Keywords
riñón, ejercicio, proteína, suplementos, AINES
Resumen
En la actualidad, se ha observado un incremento notable en la utilización de suplementos dietéticos, como los derivados de creatina, esteroides anabólicos, hormona de crecimiento y AINEs, acompañado de la adopción de dietas hiperproteicas y programas de ejercicio intensivo. Sin embargo, prevalece una amplia desinformación en este ámbito. El empleo no terapéutico de suplementos o su combinación con fármacos nefrotóxicos puede inducir o agravar patologías renales preexistentes, destacando la glomeruloesclerosis focal y segmentaria como la lesión más comúnmente identificada. En relación con el uso excesivo de AINEs, la inhibición de la síntesis de prostaglandinas conlleva principalmente a nefritis intersticial. En la mayoría de los pacientes sin patología renal subyacente, la adopción de dietas ricas en proteínas y la utilización moderada de suplementos para el desarrollo muscular no suscitan problemas renales, siempre y cuando se sigan las pautas de dosificación recomendadas.
Citas
1. Pedersen BK, Saltin B. Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports [Internet]. 2015 Dec;25:1–72. Doi: 10.1111/sms.12581
2. González K, Fuentes J, Márquez JL. Physical Inactivity, Sedentary Behavior and Chronic Diseases. Korean J Fam Med [Internet]. 2017;38(3):111. Doi: 10.4082/kjfm.2017.38.3.111
3. Garrahy E, Davison K, Hardcastle S, O’Brien J, Pederson S, Williams A, et al. Exercise as cardiovascular medicine. Aust J Gen Pract [Internet]. 2020 Aug 1;49(8):483–7. Disponible en: https://www1.racgp.org.au/ajgp/2020/august/exercise-as-cardiovascular-medicine
4. López-Torres Hidalgo J. Effectiveness of physical exercise in the treatment of depression in older adults as an alternative to antidepressant drugs in primary care. BMC Psychiatry [Internet]. 2019 Dec 14;19(1):21. Doi: 10.1186/s12888-018-1982-6
5. González-Martí I. El exceso de ejercicio físico como consecuencia del trastorno dismórfico muscular (vigorexia). TÁNDEM Didáctica la Educ Física. 2015 Apr 1;48.
6. Mitchison D, Mond J. Epidemiology of eating disorders, eating disordered behaviour, and body image disturbance in males: a narrative review. J Eat Disord [Internet]. 2015 Dec 23;3(1):20. Doi: 10.1186/s40337-015-0058-y
7. Piacentino D, Kotzalidis G, Casale A, Aromatario M, Pomara C, Girardi P, et al. Anabolic-androgenic Steroid use and Psychopathology in Athletes. A Systematic Review. Curr Neuropharmacol [Internet]. 2015 Apr 13;13(1):101–21. Disponible en: http://www.eurekaselect.com/openurl/content.php?genre=article&issn=1570-159X&volume=13&issue=1&spage=101
8. Gorrell S, Murray SB. Eating Disorders in Males. Child Adolesc Psychiatr Clin N Am [Internet]. 2019 Oct;28(4):641–51. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S1056499319300641
9. Drew RC. Baroreflex and neurovascular responses to skeletal muscle mechanoreflex activation in humans: an exercise in integrative physiology. Am J Physiol Integr Comp Physiol [Internet]. 2017 Dec 1;313(6):R654–9. Doi: 10.1152/ajpregu.00242.2017
10. Momen A, Thomas K, Blaha C, Gahremanpour A, Mansoor A, Leuenberger UA, et al. Renal vasoconstrictor responses to static exercise during orthostatic stress in humans: effects of the muscle mechano- and the baroreflexes. J Physiol [Internet]. 2006 Jun 15;573(3):819–25. Doi: 10.1113/jphysiol.2005.104612
11. Bongers CCWG, Alsady M, Nijenhuis T, Tulp ADM, Eijsvogels TMH, Deen PMT, et al. Impact of acute versus prolonged exercise and dehydration on kidney function and injury. Physiol Rep [Internet]. 2018 Jun;6(11):e13734. Doi: 10.14814/phy2.13734
12. Ogobuiro I, Tuma F. Physiology, Renal [Internet]. StatPearls. Treasure Island (FL); 2022. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK538339/%0A
13. Giebisch G, Aronson P. Fisiología Médica. In: Walter Boron EB, editor. Editorial. p. 1304.
14. Barret K, Barman S, Brooks H, Yuan J. Ganong Fisiología médica [Internet]. 26th ed. McGraw Hill, editor. 2020.
15. Levitzky M, McDonough KH. Ejercicio. In: Raff H, Levitzky M, editors. Fisiología médica Un enfoque por aparatos y sistemas [Internet]. New York, NY: McGraw-Hill Education; 2015.
16. Ravanelli N, Barry H, Schlader Z, Gagnon D. Impact of passive heat acclimation on markers of kidney function during heat stress. Exp Physiol. 2020 Jun 3;106.
17. Manuel Díaz, Jesús Briones, Raúl Carrillo, Armando Moreno, Ángel Pérez. Insuficiencia renal aguda (IRA) clasificación, fisiopatología, histopatología, cuadro clínico diagnóstico y tratamiento una versión lógica. Rev Mex Anestesiol [Internet]. 2017;40(4):280–7. Disponible en: https://www.medigraphic.com/pdfs/rma/cma-2017/cma174e.pdf
18. Tidmas V, Brazier J, Hawkins J, Forbes SC, Bottoms L, Farrington K. Nutritional and Non-Nutritional Strategies in Bodybuilding: Impact on Kidney Function. Int J Environ Res Public Health. 2022;19(7).
19. Ko GJ, Rhee CM, Kalantar-Zadeh K, Joshi S. The effects of high-protein diets on kidney health and longevity. J Am Soc Nephrol. 2020;31(8):1667–79.
20. El-Reshaid W, El-Reshaid K, Al-Bader S, Ramadan A, Madda J. Complementary bodybuilding: A potential risk for permanent kidney disease. Saudi J Kidney Dis Transplant [Internet]. 2018;29(2):326. Disponible en: http://www.sjkdt.org/text.asp?2018/29/2/326/229269
21. Antonio J, Ellerbroek A. Case reports on well-trained bodybuilders: Two years on a high protein diet. J Exerc Physiol Online. 2018 Jan 1;21:14–24.
22. Abdel Gawad M, Kalawy H. Gym nephropathy “bodybuilding versus kidney damaging.” 2019 Nov 25;
23. Almukhtar S, Ali A, Muhealdeen D, Hughson M. Acute kidney injury associated with androgenic steroids and nutritional supplements in bodybuilders. Clin Kidney J. 2015 May 26;8.
24. Snelson M, Clarke RE, Nguyen T, Penfold SA, Forbes JM, Tan SM, et al. Long Term High Protein Diet Feeding Alters the Microbiome and Increases Intestinal Permeability, Systemic Inflammation and Kidney Injury in Mice. Mol Nutr Food Res [Internet]. 2021 Apr 25;65(8):2000851.
Doi: 10.1002/mnfr.202000851
25. Taner B, Aysim O, Abdulkadir U. The effects of the recommended dose of creatine monohydrate on kidney function. Clin Kidney J [Internet]. 2011 Feb 1;4(1):23–4. Doi: 10.1093/ndtplus/sfq177
26. Williamson L, New D. How the use of creatine supplements can elevate serum creatinine in the absence of underlying kidney pathology. BMJ Case Rep. 2014 Sep 19;2014.
27. de Souza e Silva A, Pertille A, Reis Barbosa CG, Aparecida de Oliveira Silva J, de Jesus DV, Ribeiro AGSV, et al. Effects of Creatine Supplementation on Renal Function: A Systematic Review and Meta-Analysis. J Ren Nutr [Internet]. 2019 Nov;29(6):480–9. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S1051227619302286
28. Davani-Davari D, Karimzadeh I, Ezzatzadegan-Jahromi S, Sagheb M. Potential Adverse Effects of Creatine Supplement on the Kidney in Athletes and Bodybuilders. Iran J Kidney Dis. 2018 Sep 3;12:253–60.
29. Antonio J, Candow DG, Forbes SC, Gualano B, Jagim AR, Kreider RB, et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr [Internet]. 2021 Jan 2;18(1). Doi: 10.1186/s12970-021-00412-w
30. Candia-Luján R, Antonio De-Paz-Fernández J. Are Nonsteroidal Anti-Inflammatories Effective in the Treatment of Delayed Onset Muscle Soreness? Issn. 2014;9(1):76–83.
31. Morelli KM, Brown LB, Warren GL. Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. Am J Sports Med [Internet]. 2018 Jan 29;46(1):224–33. Doi: 10.1177/0363546517697957
32. Bindu S, Mazumder S, Bandyopadhyay U. Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: A current perspective. Biochem Pharmacol [Internet]. 2020 Oct;180:114147. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S000629522030383X
33. Emerson DM, Chen SC, Kelly MR, Parnell B, Torres-McGehee TM. Non-steroidal anti-inflammatory drugs on core body temperature during exercise: A systematic review. J Exerc Sci Fit [Internet]. 2021 Apr;19(2):127–33. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S1728869X20303257
34. Lundberg T, Howatson G. Analgesic and anti-inflammatory drugs in sports: Implications for exercise performance and training adaptations. Scand J Med Sci Sports. 2018 Aug 13;28.
35. Tscholl P, Gard S, Schindler M. A sensible approach to the use of NSAIDs in sports medicine. Swiss Sport Exerc Med. 2017 Jan 1;65:15–20.
36. Cornu C, Grange C, Regalin A, Munier J, Ounissi S, Reynaud N, et al. Effect of Non-Steroidal Anti-Inflammatory Drugs on Sport Performance Indices in Healthy People: a Meta-Analysis of Randomized Controlled Trials. Sport Med - Open [Internet]. 2020 Dec 28;6(1):20. Doi: 10.1186/s40798-020-00247-w
37. Brennan R, Wazaify M, Shawabkeh H, Boardley I, McVeigh J, Van Hout MC. A Scoping Review of Non-Medical and Extra-Medical Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Drug Saf [Internet]. 2021 Sep 30;44(9):917–28. Doi: 10.1007/s40264-021-01085-9
38. Lucas GNC, Leitão ACC, Alencar RL, Xavier RMF, Daher EDF, Silva Junior GB da. Pathophysiological aspects of nephropathy caused by non-steroidal anti-inflammatory drugs. Brazilian J Nephrol [Internet]. 2019 Mar;41(1):124–30. Disponible en: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002019000100124&tlng=en
39. Musu M, Finco G, Antonucci R, Polati E, Sanna D, Evangelista M, et al. Acute nephrotoxicity of NSAID from the foetus to the adult. Eur Rev Med Pharmacol Sci. 2011 Dec;15(12):1461–72.
40. Fowler C. Do nonsteroidal anti-inflammatory drugs impair tissue healing? J Am Acad Physician Assist [Internet]. 2018 Aug;31(8):1–5. Disponible en: https://journals.lww.com/01720610-201808000-00015
2. González K, Fuentes J, Márquez JL. Physical Inactivity, Sedentary Behavior and Chronic Diseases. Korean J Fam Med [Internet]. 2017;38(3):111. Doi: 10.4082/kjfm.2017.38.3.111
3. Garrahy E, Davison K, Hardcastle S, O’Brien J, Pederson S, Williams A, et al. Exercise as cardiovascular medicine. Aust J Gen Pract [Internet]. 2020 Aug 1;49(8):483–7. Disponible en: https://www1.racgp.org.au/ajgp/2020/august/exercise-as-cardiovascular-medicine
4. López-Torres Hidalgo J. Effectiveness of physical exercise in the treatment of depression in older adults as an alternative to antidepressant drugs in primary care. BMC Psychiatry [Internet]. 2019 Dec 14;19(1):21. Doi: 10.1186/s12888-018-1982-6
5. González-Martí I. El exceso de ejercicio físico como consecuencia del trastorno dismórfico muscular (vigorexia). TÁNDEM Didáctica la Educ Física. 2015 Apr 1;48.
6. Mitchison D, Mond J. Epidemiology of eating disorders, eating disordered behaviour, and body image disturbance in males: a narrative review. J Eat Disord [Internet]. 2015 Dec 23;3(1):20. Doi: 10.1186/s40337-015-0058-y
7. Piacentino D, Kotzalidis G, Casale A, Aromatario M, Pomara C, Girardi P, et al. Anabolic-androgenic Steroid use and Psychopathology in Athletes. A Systematic Review. Curr Neuropharmacol [Internet]. 2015 Apr 13;13(1):101–21. Disponible en: http://www.eurekaselect.com/openurl/content.php?genre=article&issn=1570-159X&volume=13&issue=1&spage=101
8. Gorrell S, Murray SB. Eating Disorders in Males. Child Adolesc Psychiatr Clin N Am [Internet]. 2019 Oct;28(4):641–51. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S1056499319300641
9. Drew RC. Baroreflex and neurovascular responses to skeletal muscle mechanoreflex activation in humans: an exercise in integrative physiology. Am J Physiol Integr Comp Physiol [Internet]. 2017 Dec 1;313(6):R654–9. Doi: 10.1152/ajpregu.00242.2017
10. Momen A, Thomas K, Blaha C, Gahremanpour A, Mansoor A, Leuenberger UA, et al. Renal vasoconstrictor responses to static exercise during orthostatic stress in humans: effects of the muscle mechano- and the baroreflexes. J Physiol [Internet]. 2006 Jun 15;573(3):819–25. Doi: 10.1113/jphysiol.2005.104612
11. Bongers CCWG, Alsady M, Nijenhuis T, Tulp ADM, Eijsvogels TMH, Deen PMT, et al. Impact of acute versus prolonged exercise and dehydration on kidney function and injury. Physiol Rep [Internet]. 2018 Jun;6(11):e13734. Doi: 10.14814/phy2.13734
12. Ogobuiro I, Tuma F. Physiology, Renal [Internet]. StatPearls. Treasure Island (FL); 2022. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK538339/%0A
13. Giebisch G, Aronson P. Fisiología Médica. In: Walter Boron EB, editor. Editorial. p. 1304.
14. Barret K, Barman S, Brooks H, Yuan J. Ganong Fisiología médica [Internet]. 26th ed. McGraw Hill, editor. 2020.
15. Levitzky M, McDonough KH. Ejercicio. In: Raff H, Levitzky M, editors. Fisiología médica Un enfoque por aparatos y sistemas [Internet]. New York, NY: McGraw-Hill Education; 2015.
16. Ravanelli N, Barry H, Schlader Z, Gagnon D. Impact of passive heat acclimation on markers of kidney function during heat stress. Exp Physiol. 2020 Jun 3;106.
17. Manuel Díaz, Jesús Briones, Raúl Carrillo, Armando Moreno, Ángel Pérez. Insuficiencia renal aguda (IRA) clasificación, fisiopatología, histopatología, cuadro clínico diagnóstico y tratamiento una versión lógica. Rev Mex Anestesiol [Internet]. 2017;40(4):280–7. Disponible en: https://www.medigraphic.com/pdfs/rma/cma-2017/cma174e.pdf
18. Tidmas V, Brazier J, Hawkins J, Forbes SC, Bottoms L, Farrington K. Nutritional and Non-Nutritional Strategies in Bodybuilding: Impact on Kidney Function. Int J Environ Res Public Health. 2022;19(7).
19. Ko GJ, Rhee CM, Kalantar-Zadeh K, Joshi S. The effects of high-protein diets on kidney health and longevity. J Am Soc Nephrol. 2020;31(8):1667–79.
20. El-Reshaid W, El-Reshaid K, Al-Bader S, Ramadan A, Madda J. Complementary bodybuilding: A potential risk for permanent kidney disease. Saudi J Kidney Dis Transplant [Internet]. 2018;29(2):326. Disponible en: http://www.sjkdt.org/text.asp?2018/29/2/326/229269
21. Antonio J, Ellerbroek A. Case reports on well-trained bodybuilders: Two years on a high protein diet. J Exerc Physiol Online. 2018 Jan 1;21:14–24.
22. Abdel Gawad M, Kalawy H. Gym nephropathy “bodybuilding versus kidney damaging.” 2019 Nov 25;
23. Almukhtar S, Ali A, Muhealdeen D, Hughson M. Acute kidney injury associated with androgenic steroids and nutritional supplements in bodybuilders. Clin Kidney J. 2015 May 26;8.
24. Snelson M, Clarke RE, Nguyen T, Penfold SA, Forbes JM, Tan SM, et al. Long Term High Protein Diet Feeding Alters the Microbiome and Increases Intestinal Permeability, Systemic Inflammation and Kidney Injury in Mice. Mol Nutr Food Res [Internet]. 2021 Apr 25;65(8):2000851.
Doi: 10.1002/mnfr.202000851
25. Taner B, Aysim O, Abdulkadir U. The effects of the recommended dose of creatine monohydrate on kidney function. Clin Kidney J [Internet]. 2011 Feb 1;4(1):23–4. Doi: 10.1093/ndtplus/sfq177
26. Williamson L, New D. How the use of creatine supplements can elevate serum creatinine in the absence of underlying kidney pathology. BMJ Case Rep. 2014 Sep 19;2014.
27. de Souza e Silva A, Pertille A, Reis Barbosa CG, Aparecida de Oliveira Silva J, de Jesus DV, Ribeiro AGSV, et al. Effects of Creatine Supplementation on Renal Function: A Systematic Review and Meta-Analysis. J Ren Nutr [Internet]. 2019 Nov;29(6):480–9. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S1051227619302286
28. Davani-Davari D, Karimzadeh I, Ezzatzadegan-Jahromi S, Sagheb M. Potential Adverse Effects of Creatine Supplement on the Kidney in Athletes and Bodybuilders. Iran J Kidney Dis. 2018 Sep 3;12:253–60.
29. Antonio J, Candow DG, Forbes SC, Gualano B, Jagim AR, Kreider RB, et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr [Internet]. 2021 Jan 2;18(1). Doi: 10.1186/s12970-021-00412-w
30. Candia-Luján R, Antonio De-Paz-Fernández J. Are Nonsteroidal Anti-Inflammatories Effective in the Treatment of Delayed Onset Muscle Soreness? Issn. 2014;9(1):76–83.
31. Morelli KM, Brown LB, Warren GL. Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. Am J Sports Med [Internet]. 2018 Jan 29;46(1):224–33. Doi: 10.1177/0363546517697957
32. Bindu S, Mazumder S, Bandyopadhyay U. Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: A current perspective. Biochem Pharmacol [Internet]. 2020 Oct;180:114147. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S000629522030383X
33. Emerson DM, Chen SC, Kelly MR, Parnell B, Torres-McGehee TM. Non-steroidal anti-inflammatory drugs on core body temperature during exercise: A systematic review. J Exerc Sci Fit [Internet]. 2021 Apr;19(2):127–33. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S1728869X20303257
34. Lundberg T, Howatson G. Analgesic and anti-inflammatory drugs in sports: Implications for exercise performance and training adaptations. Scand J Med Sci Sports. 2018 Aug 13;28.
35. Tscholl P, Gard S, Schindler M. A sensible approach to the use of NSAIDs in sports medicine. Swiss Sport Exerc Med. 2017 Jan 1;65:15–20.
36. Cornu C, Grange C, Regalin A, Munier J, Ounissi S, Reynaud N, et al. Effect of Non-Steroidal Anti-Inflammatory Drugs on Sport Performance Indices in Healthy People: a Meta-Analysis of Randomized Controlled Trials. Sport Med - Open [Internet]. 2020 Dec 28;6(1):20. Doi: 10.1186/s40798-020-00247-w
37. Brennan R, Wazaify M, Shawabkeh H, Boardley I, McVeigh J, Van Hout MC. A Scoping Review of Non-Medical and Extra-Medical Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Drug Saf [Internet]. 2021 Sep 30;44(9):917–28. Doi: 10.1007/s40264-021-01085-9
38. Lucas GNC, Leitão ACC, Alencar RL, Xavier RMF, Daher EDF, Silva Junior GB da. Pathophysiological aspects of nephropathy caused by non-steroidal anti-inflammatory drugs. Brazilian J Nephrol [Internet]. 2019 Mar;41(1):124–30. Disponible en: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002019000100124&tlng=en
39. Musu M, Finco G, Antonucci R, Polati E, Sanna D, Evangelista M, et al. Acute nephrotoxicity of NSAID from the foetus to the adult. Eur Rev Med Pharmacol Sci. 2011 Dec;15(12):1461–72.
40. Fowler C. Do nonsteroidal anti-inflammatory drugs impair tissue healing? J Am Acad Physician Assist [Internet]. 2018 Aug;31(8):1–5. Disponible en: https://journals.lww.com/01720610-201808000-00015
Barra lateral del artículo
Publicado
sept 5, 2023
Detalles del artículo
Cómo citar
Barrantes-Silman, P., Castillo-Cordero, A., Céspedes-Valverde, M., Delgado-Gómez, D., Jimenez-Rivera, A., & Santillan-Zúñiga, J. (2023). Interacción entre ejercicio, dieta hiperproteica, suplementos y AINEs: efectos en la función renal . Revista Hispanoamericana De Ciencias De La Salud, 9(2), 113–123. https://doi.org/10.56239/rhcs.2023.92.642
Sección
Artículos de Revisión
Esta obra está bajo una licencia internacional Creative Commons Atribución-CompartirIgual 4.0.
La RHCS usa la licencia Creative Commons 4.0 International (CC BY 4.0). Para obtener más información, visite https://creativecommons.org/licenses/by/4.0/