Adequate protein dietary restriction in diabetic and nondiabetic patients with chronic renal failure

Abstract

An adequate dietary protein restriction is accepted by patients, and it is well tolerated during a 12-month follow-up. Without any sign of malnutrition, it is possible to get near the ideal body weight and to reduce the obesity index and the body mass index, which are both well-established risk factors for developing cardiovascular pathology. In nondiabetic patients only, we observed a significant slowing of the progression of renal damage.

Macronutrients, Food Groups, and Eating Patterns in the Management of Diabetes

“…One study blinded physicians to diet treatment (75). Two studies achieved lower protein intakes of 0.86–0.89 g protein/kg/day versus usual protein intakes (1.02–1.24) (76,77), whereas in the other two studies, the lower-protein group had higher actual protein intakes versus the control groups (75,78). None of the studies found significant differences between groups for glycemia, CVD risk factors, or renal function (glomerular filtration rate [GFR], various measures of proteinuria).…”

“…Four parallel RCTs examined the effects of lower versus usual protein intake on glycemic control, CVD risk factors, and renal function markers in individuals with types 1 and 2 diabetes and microalbuminuria (75), macroalbuminuria (76,77), or both (78). Durations of follow-up ranged from 1 to 4 years, sample sizes were small (23–47 participants in the intervention groups), and retention rates were >80% in two studies (76,77).…”

“…Durations of follow-up ranged from 1 to 4 years, sample sizes were small (23–47 participants in the intervention groups), and retention rates were >80% in two studies (76,77). One study blinded physicians to diet treatment (75).…”

Dietary protein intake and renal function

“…Indeed, dietary protein restriction is a common treatment modality for patients with renal disease [55,56] and practice guidelines exist regarding reduced dietary protein intakes for individuals with chronic renal disease in which proteinuria is present [57]. The National Kidney Foundation (NKF) has extensive recommendations with regard to protein intake, which are a byproduct of the Dialysis Outcome Quality Initiative [58].…”

The Role of Dietary Proteins Among Persons with Diabetes

“…14 However, both treatment arms had a similar decline in mean eGFR when all CKD stages were evaluated. Studies by Meloni et al (Table 2) 15,16 have yielded mixed results. In the 2002 one-year trial by Meloni et al 15 diabetic patients randomized to the severe dietary protein restriction (0.6 g/kg/d) had a decrease in serum prealbumin, which raised questions about the risk of malnutrition.…”