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 < .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 < .006), and there was a significant fall in the median fractional clearance of albumin from 2.0 × 10−4 (range 0.1–90.9) on UPD to 1.0 × 10−4 (range 0.1–51.4) on LPD and IgG from 2.1 × 10−5 (range 0.2–238) to 1.5 × 10−5 (range 0.1–77) (P < .006 and P < .02, respectively). The reabsorption rate of β2-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.
Skip Nav Destination
Article navigation
Original Articles|
December 01 1988
Renal Response to Restricted Protein Intake in Diabetic Nephropathy
Jeremy J Bending;
Jeremy J Bending
Unit for Metabolic Medicine, Division of Medicine, United Medical and Dental Schools
Guy's Campus, London
Search for other works by this author on:
Rosemary A Dodds;
Rosemary A Dodds
Unit for Metabolic Medicine, Division of Medicine, United Medical and Dental Schools
Guy's Campus, London
Search for other works by this author on:
H Keen;
H Keen
Unit for Metabolic Medicine, Division of Medicine, United Medical and Dental Schools
Guy's Campus, London
Search for other works by this author on:
Gian Carlo Viberti
Gian Carlo Viberti
Unit for Metabolic Medicine, Division of Medicine, United Medical and Dental Schools
Guy's Campus, London
Search for other works by this author on:
Address correspondence and reprint requests to Professor G.C. Viberti, Unit for Metabolic Medicine, 4th Floor Hunt's House, Guy's Hospital, London SE1 9RT.
Diabetes 1988;37(12):1641–1646
Article history
Received:
July 15 1987
Revision Received:
June 02 1988
Accepted:
June 02 1988
PubMed:
3192038
Citation
Jeremy J Bending, Rosemary A Dodds, H Keen, Gian Carlo Viberti; Renal Response to Restricted Protein Intake in Diabetic Nephropathy. Diabetes 1 December 1988; 37 (12): 1641–1646. https://doi.org/10.2337/diab.37.12.1641
Download citation file:
151
Views