Effect of weight loss using formula diet on renal function in obese patients with diabetic nephropathy.
OBJECTIVE
To evaluate the effect and safety of treatment with low-calorie formula diet on renal function and proteinuria in obese patients with diabetic nephropathy.


METHODS
Prospective study on safety and efficacy of a 4-week low-calorie (11-19 kcal/kg/day) normal-protein (0.9-1.2 g/kg/day) diet partly supplemented with formula diet.


METHODS
In all, 22 obese patients with diabetic nephropathy (BMI: 30.4+/-5.3 kg/m(2), HbA1c: 7.1+/-1.4%, serum creatinine: 172.4+/-57.5 micromol/l, urinary protein: 3.3+/-2.6 g/day).


RESULTS
The mean body weight decreased by 6.2+/-3.0 kg. The mean systolic blood pressure, creatinine, blood urea nitrogen, urinary protein, and 8-hydroxydeoxyguanosine decreased significantly by 7.5+/-12.7 mmHg, 41.6+/-23.9 micromol/l, 1.50+/-1.61 mmol/l, 1.8+/-1.7 g/day, and 3.1+/-3.6 ng/mg creatinine, respectively. No patient had increased serum creatinine and urinary protein. Mean creatinine clearance (40.6+/-17.9 to 46.1+/-14.6 ml/s/1.73 m(2)) and serum albumin showed no significant changes. Delta serum creatinine and Delta urinary protein correlated with Delta body weight (r=0.62 and 0.49, respectively) and Delta visceral fat area (r=0.58 and 0.58, respectively), but did not correlate with Delta systolic blood pressure, Delta fasting blood glucose and Delta subcutaneous fat area.


CONCLUSIONS
These results suggested that weight reduction using formula diet might improve renal function and proteinuria safely for a short term in obese patients with diabetic nephropathy.
Saiki
A
A
Center of Diabetes, Endocrine and Metabolism, Sakura Hospital, School of Medicine, Toho University, Chiba, Japan.
Nagayama
D
D
Ohhira
M
M
Endoh
K
K
Ohtsuka
M
M
Koide
N
N
Oyama
T
T
Miyashita
Y
Y
Shirai
K
K
D000273:Adipose Tissue / Q000503:physiopathology; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure / Q000502:physiology; D003404:Creatinine / Q000097:blood; D003928:Diabetic Nephropathies / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D004044:Dietary Proteins / Q000008:administration & dosage / Q000652:urine; D002149:Energy Intake / Q000502:physiology; D005260:Female; D005526:Food, Formulated; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000178:diet therapy / Q000503:physiopathology*; D018384:Oxidative Stress / Q000502:physiology; D011446:Prospective Studies; D011507:Proteinuria / Q000150:complications / Q000378:metabolism / Q000503:physiopathology; D015431:Weight Loss / Q000502:physiology*
D001786:Blood Glucose; D004044:Dietary Proteins; D003404:Creatinine