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A randomized trial of low-protein diet in type 1 and in type 2 diabetes mellitus patients with incipient and overt nephropathy.
J Ren Nutr. 2005 Oct; 15(4):398-406.JR

Abstract

OBJECTIVE

The efficacy of a low-protein diet in the secondary prevention of diabetic nephropathy is not established in patients with type 1 or type 2 diabetes mellitus. To determine whether a low-protein diet slows the decrease in glomerular filtration rate (GFR) and decreases the albumin excretion rate (AER) in diabetic patients with incipient and overt nephropathy, we performed a 2-year prospective, randomized controlled trial comparing the effects of a low-protein diet (0.8 g/kg/day) with a usual-protein diet.

SETTING AND PATIENTS

The study was conducted in a University hospital and included 63 type 1 and type 2 diabetic patients with either incipient or overt nephropathy and mild renal failure (prestudy GFR, 80 +/- 20 mL/min). The primary outcome measures were decreased in GFR and 24-hour AER.

RESULTS

In the low-protein-diet group, patients were younger (52 +/- 12 versus 63 +/- 9 years old) and more often were type 2 diabetic. During the follow-up period, according to dietary records the low-protein-diet group consumed 16% +/- 3% of total caloric intakes as compared with 19% +/- 4% in the usual-protein-diet group (P < .02), but 24-hour urinary urea excretions did not differ between the two groups. The 2-year GFR decrease was 7 +/- 11 mL/min in the low-protein-diet group and 5 +/- 15 mL/min in the usual-protein-diet group (P = not significant). AER did not increase significantly in the two diet groups during the follow-up period. Blood pressure and glycemic control were similar in the two groups all along the study. The decrease in GFR and AER were also similar in 6 compliant patients according to dietary records and to 24-hour urinary urea excretions from the low-protein-diet group and in 12 patients from the usual-protein-diet group.

CONCLUSIONS

A 2-year low-protein diet did not alter the course of GFR or of AER in diabetic patients with incipient or overt nephropathy receiving renin-angiotensin blockers with strict blood pressure control.

Authors+Show Affiliations

Centre d'Investigation Clinique, INSERM-APHM, Marseille, France. bdussol@ap-hm.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16198932

Citation

Dussol, Bertrand, et al. "A Randomized Trial of Low-protein Diet in Type 1 and in Type 2 Diabetes Mellitus Patients With Incipient and Overt Nephropathy." Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, vol. 15, no. 4, 2005, pp. 398-406.
Dussol B, Iovanna C, Raccah D, et al. A randomized trial of low-protein diet in type 1 and in type 2 diabetes mellitus patients with incipient and overt nephropathy. J Ren Nutr. 2005;15(4):398-406.
Dussol, B., Iovanna, C., Raccah, D., Darmon, P., Morange, S., Vague, P., Vialettes, B., Oliver, C., Loundoun, A., & Berland, Y. (2005). A randomized trial of low-protein diet in type 1 and in type 2 diabetes mellitus patients with incipient and overt nephropathy. Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, 15(4), 398-406.
Dussol B, et al. A Randomized Trial of Low-protein Diet in Type 1 and in Type 2 Diabetes Mellitus Patients With Incipient and Overt Nephropathy. J Ren Nutr. 2005;15(4):398-406. PubMed PMID: 16198932.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized trial of low-protein diet in type 1 and in type 2 diabetes mellitus patients with incipient and overt nephropathy. AU - Dussol,Bertrand, AU - Iovanna,Cecilia, AU - Raccah,Denis, AU - Darmon,Patrice, AU - Morange,Sophie, AU - Vague,Philippe, AU - Vialettes,Bernard, AU - Oliver,Charles, AU - Loundoun,Anderson, AU - Berland,Yvon, PY - 2004/12/09/received PY - 2005/10/4/pubmed PY - 2006/5/27/medline PY - 2005/10/4/entrez SP - 398 EP - 406 JF - Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation JO - J Ren Nutr VL - 15 IS - 4 N2 - OBJECTIVE: The efficacy of a low-protein diet in the secondary prevention of diabetic nephropathy is not established in patients with type 1 or type 2 diabetes mellitus. To determine whether a low-protein diet slows the decrease in glomerular filtration rate (GFR) and decreases the albumin excretion rate (AER) in diabetic patients with incipient and overt nephropathy, we performed a 2-year prospective, randomized controlled trial comparing the effects of a low-protein diet (0.8 g/kg/day) with a usual-protein diet. SETTING AND PATIENTS: The study was conducted in a University hospital and included 63 type 1 and type 2 diabetic patients with either incipient or overt nephropathy and mild renal failure (prestudy GFR, 80 +/- 20 mL/min). The primary outcome measures were decreased in GFR and 24-hour AER. RESULTS: In the low-protein-diet group, patients were younger (52 +/- 12 versus 63 +/- 9 years old) and more often were type 2 diabetic. During the follow-up period, according to dietary records the low-protein-diet group consumed 16% +/- 3% of total caloric intakes as compared with 19% +/- 4% in the usual-protein-diet group (P < .02), but 24-hour urinary urea excretions did not differ between the two groups. The 2-year GFR decrease was 7 +/- 11 mL/min in the low-protein-diet group and 5 +/- 15 mL/min in the usual-protein-diet group (P = not significant). AER did not increase significantly in the two diet groups during the follow-up period. Blood pressure and glycemic control were similar in the two groups all along the study. The decrease in GFR and AER were also similar in 6 compliant patients according to dietary records and to 24-hour urinary urea excretions from the low-protein-diet group and in 12 patients from the usual-protein-diet group. CONCLUSIONS: A 2-year low-protein diet did not alter the course of GFR or of AER in diabetic patients with incipient or overt nephropathy receiving renin-angiotensin blockers with strict blood pressure control. SN - 1532-8503 UR - https://www.unboundmedicine.com/medline/citation/16198932/A_randomized_trial_of_low_protein_diet_in_type_1_and_in_type_2_diabetes_mellitus_patients_with_incipient_and_overt_nephropathy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1051-2276(05)00115-9 DB - PRIME DP - Unbound Medicine ER -