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Effect of Restricting Dietary Protein on the Progression of Renal Failure in Patients with Insulin‐Dependent Diabetes Mellitus K. ZELLER, E. WHITTAKER, L. SULLIVAN, P. RASKIN, H.R. JACOBSON N Engl J Med 324:78–84, 1991
Author(s) -
Kearns Patrick J.
Publication year - 1991
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607191015006685
Subject(s) - medicine , renal function , proteinuria , endocrinology , diabetes mellitus , creatinine , prospective cohort study , insulin , gastroenterology , urology , kidney
This report compares the progression of renal failure in type‐I diabetic patients fed either a low or a normal protein diet. In a prospective, randomized, controlled fashion, 47 adult patients were placed either on a 0.6 g/ kg daily protein intake (study) or a greater than 1.0 g/ kg (control) daily protein intake. Dietary phosphorus was maintained between 0.5 and 1.0 g for study patients and greater than 1.0 g for control patients. Renal function was monitored by iothalamate and creatinine clearance measurements at 3‐ to 6‐month intervals. Patients were studied for periods up to 46 months (mean 34.7 months). Study patients had a slower deterioration of renal function with clearance decreasing at 25 to 40% the rate observed in control patients. Proteinuria was reduced by 45% in the study group when compared to the control group (2.9 g/dL vs 5.4 g/dL). The authors conclude that a protein‐phosphorus‐restricted diet can slow progression of renal failure in diabetic patients.