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Effect of protein restriction in insulin dependent diabetics at risk of nephropathy.
Br Med J (Clin Res Ed). 1987 Mar 28; 294(6575):795-8.BM

Abstract

Persistent proteinuria is strongly associated with increased mortality in insulin dependent diabetes, and risk of this condition can be predicted many years in advance by subclinical increases in albumin excretion rate (microalbuminuria). Eight normotensive insulin dependent diabetics with microalbuminuria who had overnight albumin excretion rates of between 15 and 200 micrograms/min underwent a three week randomised crossover study of their normal protein diet (median 92 (range 55-117) g/day) and a low protein diet (47 (38-57) g/day). Both diets were isoenergetic, and the low protein diet was supplemented with calcium and phosphate. Median overnight albumin excretion rate fell from 23.0 (15.0-170.1) micrograms/min during the normal diet to 15.4 (4.1-97.8) micrograms/min during the low protein diet. No consistent change was found in urinary excretion of beta 2 microglobulin during the two diets. The reduction in albumin excretion rate was accompanied by a significant fall in median glomerular filtration rate and fractional renal clearance of albumin. Kidney volume remained unchanged. There were no significant changes in glycaemic control or arterial blood pressure. In these few patients restriction of dietary protein had a beneficial effect on microalbuminuria, independent of changes in glucose concentrations and arterial blood pressure.

Links

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Authors

Cohen D
No affiliation info available
Dodds R
No affiliation info available
Viberti G
No affiliation info available

MeSH

AdolescentAdultAlbuminuriaBlood GlucoseChildDiabetes Mellitus, Type 1Dietary ProteinsFemaleGlomerular Filtration RateHumansKidney DiseasesMaleMiddle AgedProteinuriaRandom Allocation

Pub Type(s)

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

Language

eng

PubMed ID

3105747

Citation

Cohen, D, et al. "Effect of Protein Restriction in Insulin Dependent Diabetics at Risk of Nephropathy." British Medical Journal (Clinical Research Ed.), vol. 294, no. 6575, 1987, pp. 795-8.
Cohen D, Dodds R, Viberti G. Effect of protein restriction in insulin dependent diabetics at risk of nephropathy. Br Med J (Clin Res Ed). 1987;294(6575):795-8.
Cohen, D., Dodds, R., & Viberti, G. (1987). Effect of protein restriction in insulin dependent diabetics at risk of nephropathy. British Medical Journal (Clinical Research Ed.), 294(6575), 795-8.
Cohen D, Dodds R, Viberti G. Effect of Protein Restriction in Insulin Dependent Diabetics at Risk of Nephropathy. Br Med J (Clin Res Ed). 1987 Mar 28;294(6575):795-8. PubMed PMID: 3105747.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of protein restriction in insulin dependent diabetics at risk of nephropathy. AU - Cohen,D, AU - Dodds,R, AU - Viberti,G, PY - 1987/3/28/pubmed PY - 1987/3/28/medline PY - 1987/3/28/entrez SP - 795 EP - 8 JF - British medical journal (Clinical research ed.) JO - Br Med J (Clin Res Ed) VL - 294 IS - 6575 N2 - Persistent proteinuria is strongly associated with increased mortality in insulin dependent diabetes, and risk of this condition can be predicted many years in advance by subclinical increases in albumin excretion rate (microalbuminuria). Eight normotensive insulin dependent diabetics with microalbuminuria who had overnight albumin excretion rates of between 15 and 200 micrograms/min underwent a three week randomised crossover study of their normal protein diet (median 92 (range 55-117) g/day) and a low protein diet (47 (38-57) g/day). Both diets were isoenergetic, and the low protein diet was supplemented with calcium and phosphate. Median overnight albumin excretion rate fell from 23.0 (15.0-170.1) micrograms/min during the normal diet to 15.4 (4.1-97.8) micrograms/min during the low protein diet. No consistent change was found in urinary excretion of beta 2 microglobulin during the two diets. The reduction in albumin excretion rate was accompanied by a significant fall in median glomerular filtration rate and fractional renal clearance of albumin. Kidney volume remained unchanged. There were no significant changes in glycaemic control or arterial blood pressure. In these few patients restriction of dietary protein had a beneficial effect on microalbuminuria, independent of changes in glucose concentrations and arterial blood pressure. SN - 0267-0623 UR - https://www.unboundmedicine.com/medline/citation/3105747/Effect_of_protein_restriction_in_insulin_dependent_diabetics_at_risk_of_nephropathy_ DB - PRIME DP - Unbound Medicine ER -