Effect of moderate dietary protein restriction on the progression of overt diabetic nephropathy: a 6-mo prospective study.
To assess whether moderate dietary protein restriction can delay the progression of overt diabetic nephropathy, 22 subjects with insulin-dependent diabetes mellitus were randomly assigned to an unrestricted protein diet (> 1.6 g.kg body wt-1.d-1) or a moderately protein-restricted diet (0.8 g.kg body wt-1.d-1) and followed prospectively for six mo. Direct isotope methods were used to assess renal function. Protein intake was assessed by measurement of urinary urea nitrogen. The two groups were well-matched for age, sex, duration of diabetes, glycemic control, blood pressure, and degree of renal insufficiency. Patients consuming the unrestricted protein diet (n = 11) showed a progressive decline in glomerular filtration rate of 1.3 mL.min-1.mo-1 with no change in proteinuria. Patients consuming the moderately protein-restricted diet showed a marked decrease in the degree of proteinuria (2.15-1.13 g/d, P = 0.036) and a stabilization of glomerular filtration rate. This occurred independently of changes in blood pressure or glycemic control. Moderate dietary protein restriction can ameliorate progression of overt diabetic nephropathy.
Raal
F J
FJ
Division of Endocrinology and Metabolism, University of the Witwatersrand Medical School, Johannesburg, South Africa.
Kalk
W J
WJ
Lawson
M
M
Esser
J D
JD
Buys
R
R
Fourie
L
L
Panz
V R
VR
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002784:Cholesterol / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000178:diet therapy* / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000503:physiopathology / Q000517:prevention & control*; D004044:Dietary Proteins / Q000008:administration & dosage*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011507:Proteinuria / Q000652:urine; D014280:Triglycerides / Q000097:blood; D014508:Urea / Q000652:urine
D001786:Blood Glucose; D004044:Dietary Proteins; D014280:Triglycerides; D014508:Urea; D002784:Cholesterol