Nephrology Dialysis Transplantation, Vol 13, Issue 90008 49-52, Copyright © 1998 by Oxford University Press
G Barsotti, A Cupisti, M Barsotti, S Sposini, D Palmieri, M Meola, C Lenti and E Morelli
Thirty-two patients with diabetes mellitus (22 IDDM and 10 NIDDM, 21 males
and 11 females age 44±11.8 years) were followed for
5.2±3.8 years after the onset of chronic renal failure, with the
aim of evaluating the effect of low protein diets on the rate of decline of
the residual renal function. During the 1.8±1.6 year follow-up
period on free or uncontrolled low protein diet the mean rate of decline of
creatinine clearance was 0.9±0.6 ml/min/month, significantly
greater than that observed during 3.7±3.1 years on low or very
low protein diets. The reduction of protein intake was followed by a
significant decrease in daily urinary protein loss. A better glycaemic
control was obtained on the low protein diet, and the daily insulin
requirement decreased. The anthropometry, as well as the serum
concentrations of rapid turnover proteins, did not change, in spite of the
low or very low protein dietary supply for a long duration. The values of
mean arterial pressure were quite similar during the follow-up period on
free or uncontrolled low protein diet and during the study period on the
low protein diet. A good compliance with reduced dietary intake (as
demonstrated by the measurement of the daily urea excretion) was obtained
in a large number of patients. In conclusion, our study confirms the
protective effect on the residual renal function of low protein diets in
IDDM and NIDDM patients with chronic renal failure due to diabetic
nephropathy, in the absence of any sign of protein
malnutrition.Key words: chronic renal failure;
diabetic nephropathy; low protein diet
ORIGINAL ARTICLES
Dietary treatment of diabetic nephropathy with chronic renal failure
Department of Internal Medicine, Ospedale S Chiara, Via Roma, 67, 56126 Pisa, Italy; Corresponding author
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