Document Detail


Protein restriction, glomerular filtration rate and albuminuria in patients with type 2 diabetes mellitus: a randomized trial.
MedLine Citation:
PMID:  12494305     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Protein restriction delays the progression of non-diabetic and type 1 diabetic renal disorders. This study assessed whether protein restriction delays the onset or early progression of renal disorders in type 2 diabetes. DESIGN: Randomized controlled trial. Outcomes were albuminuria (mg/24 h) and, as an estimate of the glomerular filtration rate, cimetidine-influenced creatinine clearance. SETTING: Primary care. SUBJECTS: Patients with type 2 diabetes and microalbuminuria or at least detectable albuminuria, or a diabetes duration >5 y. INTERVENTIONS: The experimental group received dietary counselling on protein restriction (n=63); a control group (n=68) received the usual dietary advice. The duration of intervention and follow-up was 28+/-7 months. RESULTS: After 6 months, protein intake differed only by 0.08 g/kg/day between the study groups. Subsequently, this difference decreased and eventually disappeared. An initial effect of protein restriction on albuminuria in favor of the experimental group was not sustained, and the glomerular filtration rate decreased in the experimental group at a 1.6+/-2.2 ml/min/1.73 m(2) y lower rate than in the control group (P=0.5). Comparison of patients in the experimental group with a decrease in protein intake of at least 0.20 g/kg/day, with controls with no decrease, indicated a similarly small and insignificant effect on glomerular filtration rate. CONCLUSIONS: It is concluded that, in the longer term prevention or delay of renal damage in patients with type 2 diabetes, protein restriction is neither feasible nor efficacious.
Authors:
L T J Pijls; H de Vries; J Th M van Eijk; A J M Donker
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of clinical nutrition     Volume:  56     ISSN:  0954-3007     ISO Abbreviation:  Eur J Clin Nutr     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-12-20     Completed Date:  2003-05-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8804070     Medline TA:  Eur J Clin Nutr     Country:  England    
Other Details:
Languages:  eng     Pagination:  1200-7     Citation Subset:  IM    
Affiliation:
Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands. loek.pijls@gr.nl
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MeSH Terms
Descriptor/Qualifier:
Aged
Albuminuria / prevention & control*
Diabetes Mellitus, Type 2 / complications*,  diet therapy,  physiopathology
Diabetic Nephropathies / prevention & control*
Diet, Protein-Restricted*
Dietary Proteins / administration & dosage
Female
Follow-Up Studies
Glomerular Filtration Rate*
Humans
Male
Middle Aged
Treatment Outcome
Chemical
Reg. No./Substance:
0/Dietary Proteins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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