Low-protein diet for diabetic nephropathy: a meta-analysis of randomized controlled trials - PubMed (original) (raw)
Meta-Analysis
doi: 10.1093/ajcn/88.3.660.
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- PMID: 18779281
- DOI: 10.1093/ajcn/88.3.660
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Meta-Analysis
Low-protein diet for diabetic nephropathy: a meta-analysis of randomized controlled trials
Yu Pan et al. Am J Clin Nutr. 2008 Sep.
Free article
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.
Comment in
- Do low-protein diets retard the loss of kidney function in patients with diabetic nephropathy?
Kopple JD. Kopple JD. Am J Clin Nutr. 2008 Sep;88(3):593-4. doi: 10.1093/ajcn/88.3.593. Am J Clin Nutr. 2008. PMID: 18779271 No abstract available. - The effect of a low-protein diet for diabetic nephropathy is underestimated.
Rigalleau V, Raffaitin C, Gin H, Lasseur C, Chauveau P, Aparicio M, Combe C. Rigalleau V, et al. Am J Clin Nutr. 2009 Apr;89(4):1277-8; author reply 1278-9. doi: 10.3945/ajcn.2008.27123. Epub 2009 Feb 25. Am J Clin Nutr. 2009. PMID: 19244375 No abstract available.
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