title: Severe dietary protein restriction in overt diabetic nephropathy: benefits or risks?
abstract: OBJECTIVE
  To evaluate whether restricting protein intake may delay the progression of chronic renal failure caused by overt diabetic nephropathy and also whether this increases the risk of malnutrition.
  
  
  METHODS
  Prospective clinical trial.
  
  
  METHODS
  Nephrology outpatients.
  
  
  METHODS
  Sixty-nine patients (32 affected by type 1 and 37 by type 2 diabetes, all treated with insulin) affected by both overt diabetic nephropathy and hypertension.
  
  
  METHODS
  The study was started once hypertension and glycemia had been under control for at least 3 months. Two groups of patients, matched for similar mean glomerular filtration rate value and nutritional status, were studied: a low-protein diet (0.6 g/kg/d) was randomly prescribed to 35 patients, whereas in the other 34 patients a free diet intake was maintained for 12 months.
  
  
  METHODS
  Renal function and nutritional status.
  
  
  RESULTS
  The protein intake was significantly different in the 2 groups of patients, whereas the average decline of glomerular filtration rate during the follow-up was comparable. In the low-protein diet group, serum prealbumin concentration significantly decreased after 9 months, whereas serum albumin decreased at the end of the study.
  
  
  CONCLUSIONS
  Severe dietary protein restriction does not seem to delay the progression of renal disease in patients with overt diabetic nephropathy, whereas it may induce malnutrition.
authors.affiliation: O.U. Nephrology and Dialysis, S. Eugenio Hospital, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Meloni
authors.forename: Massimo
authors.initials: M
authors.lastname: Morosetti
authors.forename: Concetta
authors.initials: C
authors.lastname: Suraci
authors.forename: Maria G
authors.initials: MG
authors.lastname: Pennafina
authors.forename: Carmela
authors.initials: C
authors.lastname: Tozzo
authors.forename: Massimo
authors.initials: M
authors.lastname: Taccone-Gallucci
authors.forename: Carlo U
authors.initials: CU
authors.lastname: Casciani
mesh_terms: D000328:Adult; D000368:Aged; D003928:Diabetic Nephropathies / Q000178:diet therapy*; D018753:Diet, Protein-Restricted; D004044:Dietary Proteins / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000178:diet therapy*; D008297:Male; D008875:Middle Aged; D009748:Nutrition Disorders / Q000209:etiology*; D009752:Nutritional Status / Q000502:physiology; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D004044:Dietary Proteins