Low-protein diet for diabetic nephropathy: a meta-analysis of randomized controlled trials.

Abstract

BACKGROUND:

A low-protein diet (LPD) has been proposed for many years to delay the progression of diabetic nephropathy. However, the efficacy of an LPD with respect to renal outcome is disputed.

OBJECTIVE:

We aimed to determine the effect of an LPD on renal function in patients with type 1 or 2 diabetic renal diseases by using a meta-analysis of randomized controlled trials.

DESIGN:

Medline, EMBASE, and the Cochrane Central Register of Controlled Trials were searched. Eight studies met the inclusion criteria for our meta-analysis: a duration of >6 mo, use of a randomized control group, availability of outcome data for changes in glomerular filtration rate (GFR) or creatinine clearance rate (CCR), and albuminuria or proteinuria in patients with type 1 or 2 diabetic nephropathy. Data were combined by means of a fixed-effects model. Weighted mean differences (WMD) were calculated for the change in GFR or CCR, glycated hemoglobin (HbA(1c)), and serum albumin between the LPD and control groups. A random-effects model was also used to calculate the standardized mean difference for the change in urinary albumin excretion or proteinuria.

RESULTS:

Overall, a change in WMD for GFR or CCR was not significantly associated with an LPD, but a decrease in WMD for HbA(1c) was significant in the LPD group (P = 0.005). Although the benefit of LPD therapy on proteinuria was significant (P = 0.003), great heterogeneity was observed. In a subgroup analysis, LPD resulted in lower serum albumin concentrations.

CONCLUSION:

LPD was not associated with a significant improvement of renal function in patients with either types 1 or 2 diabetic nephropathy.

• Authors: Yu Pan, Li Li Guo, Hui Min Jin
• Journal: The American journal of clinical nutrition (Am J Clin Nutr) Vol. 88 Issue 3 Pg. 660-6 (Sep 2008) ISSN: 1938-3207 [Electronic] United States
• PMID: 18779281 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)

Chemical References

• Glycated Hemoglobin A

Topics

• Adult
• Diabetes Mellitus, Type 1 (complications)
• Diabetes Mellitus, Type 2 (complications)
• Diabetic Nephropathies (diet therapy)
• Diet, Protein-Restricted
• Female
• Glomerular Filtration Rate
• Glycated Hemoglobin (metabolism)
• Humans
• Male
• Proteinuria (prevention & control)
• Randomized Controlled Trials as Topic