Effects of diet-therapy on urinary protein excretion albuminuria and renal haemodynamic function in obese diabetic patients with overt nephropathy
1989
Solerte, S.B. | Fioravanti, M. | Schifino, N. | Ferrari, E.
Twenty-four type 1 and type 2 diabetic patients with obesity and overt nephropathy were studied for 12 months after hypocaloric diet change from 1870 to 1410 kcal/day, (without changes of protein:carbohydrate ratio). Several parameters were evaluated: arterial blood pressure, blood glucose, fructosamine, HbA1c, proteinuria, albuminuria, glomerular filtration rate (GFR), creatinine clearance, triglycerides, HDL and total cholesterol. A significant reduction of body weight (body mass index from 33 +/- 1.6 to 26 +/- 1.8 kg/m2, P<0.001), concomitantly with a decrease of blood pressure levels (P<0.002) was demonstrated at the end of the study. Triglyceride (P<0.002), HDL (P<0.002), HDL (P<0.05) and total cholesterol (P<0.01) levels were reduced after diet-therapy, while a mild improvement of glycometabolic profile was observed in the same period. A marked decrease of proteinuria (from 1280 +/- 511 to 623 +/- 307 mg/24 h, P<0.01) and albuminuria (from 723 +/- 388 to 492 +/- 170 microgram/min, P<0.01), and an improvement of GFR (from 66 +/- 13 to 81 +/- 11 ml/min/1.73 m2, P<0.01) and creatinine clearance (from 79 +/- 14 to 91 +/- 13 ml/min, P<0.01) was demonstrated after 12 months of diet-treatment. Our data suggest that body weight reduction by hypocaloric diet may delay the progression of clinical nephropathy in obese diabetic patients.
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