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Renal response to restricted protein intake in diabetic nephropathy.
Diabetes. 1988 Dec; 37(12):1641-6.D

Abstract

Proteinuria in diabetes is associated with progressive glomerular damage. We studied the effects of 3-wk dietary protein restriction on proteinuria and renal function in 10 insulin-dependent diabetic men with diabetic nephropathy. Patients were randomly assigned by a crossover design to 40-g low-protein diet (LPD) or usual-protein diet (UPD). Glomerular filtration rate and renal plasma flow were measured by inulin and p-aminohippurate clearance at the end of each period under conditions of sustained euglycemia. Total calorie intake, body weight, serum albumin and total protein concentrations, hematocrit, blood pressure, and glucose control were similar during the two diets. Achieved protein intake was 46 +/- 3 g/day during LPD and 81 +/- 4 g/day during UPD (P less than .001). Urinary urea appearance and plasma urea were significantly lower on LPD. Median total urinary protein was reduced from 3.9 g/day (range 0.5-12.3) on UPD to 2.4 (range 0.2-9.0) on LPD (P less than .006), and there was a significant fall in the median fractional clearance of albumin from 2.0 x 10(-4) (range 0.1-90.9) on UPD to 1.0 x 10(-4) (range 0.1-51.4) on LPD and IgG from 2.1 x 10(-5) (range 0.2-238) to 1.5 x 10(-5) (range 0.1-77) (P less than .006 and P less than .02, respectively). The reabsorption rate of beta 2-microglobulin was similar on the two diets and glomerular filtration rate, renal plasma flow, and filtration fraction remained unchanged. Thus, short-term dietary protein restriction reduces diabetic proteinuria independently of blood glucose or systemic blood pressure changes by improving glomerular permselectivity.

Authors+Show Affiliations

Bending JJ
Division of Medicine, United Medical School, London.
Dodds RA
No affiliation info available
Keen H
No affiliation info available
Viberti GC
No affiliation info available

MeSH

AdultBlood GlucoseBlood PressureBody WeightDiabetic NephropathiesDietary ProteinsGlomerular Filtration RateHumansKidneyMaleMiddle AgedProteinuriaRenal CirculationUrodynamics

Pub Type(s)

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

Language

eng

PubMed ID

3192038

Citation

Bending, J J., et al. "Renal Response to Restricted Protein Intake in Diabetic Nephropathy." Diabetes, vol. 37, no. 12, 1988, pp. 1641-6.
Bending JJ, Dodds RA, Keen H, et al. Renal response to restricted protein intake in diabetic nephropathy. Diabetes. 1988;37(12):1641-6.
Bending, J. J., Dodds, R. A., Keen, H., & Viberti, G. C. (1988). Renal response to restricted protein intake in diabetic nephropathy. Diabetes, 37(12), 1641-6.
Bending JJ, et al. Renal Response to Restricted Protein Intake in Diabetic Nephropathy. Diabetes. 1988;37(12):1641-6. PubMed PMID: 3192038.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Renal response to restricted protein intake in diabetic nephropathy. AU - Bending,J J, AU - Dodds,R A, AU - Keen,H, AU - Viberti,G C, PY - 1988/12/1/pubmed PY - 1988/12/1/medline PY - 1988/12/1/entrez SP - 1641 EP - 6 JF - Diabetes JO - Diabetes VL - 37 IS - 12 N2 - Proteinuria in diabetes is associated with progressive glomerular damage. We studied the effects of 3-wk dietary protein restriction on proteinuria and renal function in 10 insulin-dependent diabetic men with diabetic nephropathy. Patients were randomly assigned by a crossover design to 40-g low-protein diet (LPD) or usual-protein diet (UPD). Glomerular filtration rate and renal plasma flow were measured by inulin and p-aminohippurate clearance at the end of each period under conditions of sustained euglycemia. Total calorie intake, body weight, serum albumin and total protein concentrations, hematocrit, blood pressure, and glucose control were similar during the two diets. Achieved protein intake was 46 +/- 3 g/day during LPD and 81 +/- 4 g/day during UPD (P less than .001). Urinary urea appearance and plasma urea were significantly lower on LPD. Median total urinary protein was reduced from 3.9 g/day (range 0.5-12.3) on UPD to 2.4 (range 0.2-9.0) on LPD (P less than .006), and there was a significant fall in the median fractional clearance of albumin from 2.0 x 10(-4) (range 0.1-90.9) on UPD to 1.0 x 10(-4) (range 0.1-51.4) on LPD and IgG from 2.1 x 10(-5) (range 0.2-238) to 1.5 x 10(-5) (range 0.1-77) (P less than .006 and P less than .02, respectively). The reabsorption rate of beta 2-microglobulin was similar on the two diets and glomerular filtration rate, renal plasma flow, and filtration fraction remained unchanged. Thus, short-term dietary protein restriction reduces diabetic proteinuria independently of blood glucose or systemic blood pressure changes by improving glomerular permselectivity. SN - 0012-1797 UR - https://www.unboundmedicine.com/medline/citation/3192038/Renal_response_to_restricted_protein_intake_in_diabetic_nephropathy_ DB - PRIME DP - Unbound Medicine ER -