[The role of the diet as a risk factor for the development and progression of diabetic nephropathy].
Diabetic nephropathy (DN) is the leading cause of kidney disease in patients starting renal replacement therapy, and affects up to 40% of type 1 and type 2 diabetic patients. Diet seems to play an important role in the development of the disease. There are evidences supporting the concept that not only the amount but also the origin of dietary protein are associated with DN. Few studies analyzed the role of dietary lipids. A low-protein diet slows down the decline of renal function and ameliorates the DN prognosis and death in patients with type 1 diabetes with micro- and macroalbuminuria. Studies in type 2 diabetic patients are scanty but short-term studies suggest that this approach decreases albuminuria. However, the use of low-protein diet for long periods is compromised by poor compliance and its long-term safety is not firmly established. Enthusiastic results come up when comparing the effect of different sources of animal protein on renal function and lipid profile in patients with DN, which may represent an alternative strategy for low-protein diet on medical nutritional therapy in patients with DN and in cardiovascular risk factors and endothelial function.
Mello
Vanessa D F de
VD
Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS.
Azevedo
Mirela J de
MJ
Zelmanovitz
Themis
T
Gross
Jorge L
JL
D000419:Albuminuria / Q000517:prevention & control; D003928:Diabetic Nephropathies / Q000178:diet therapy / Q000209:etiology / Q000517:prevention & control*; D018753:Diet, Protein-Restricted; D018450:Disease Progression; D006801:Humans; D007676:Kidney Failure, Chronic / Q000517:prevention & control; D012307:Risk Factors