Introduction: Diabetes mellitus (DM) is a non-communicable
disease that affects various organs of our body by micro as well as macro
vascular dysfunction. Diabetic kidney disease (DKD) is the most common cause of
end-stage kidney disease (ESKD) in developed countries [1]. It is thought to be
a micro vascular issue that impacts both type 1 (T1DM) and type 2 (T2DM)
diabetic patients. Chronic albuminuria and a progressive decrease in glomerular
filtration rate are the hallmarks of the condition. Strong evidence suggests
that early treatment of the illness can halt or delay its progression.
The estimated GFR (eGFR) and urine albuminuria are two
trustworthy diagnostics for diagnosis and monitoring. Adequate blood pressure
management and ideal glycemia are necessary to halt the advancement of diabetic
kidney disease (DKD) [2]. The study aims to provide valuable insights into the
effectiveness of dietary management in ameliorating renal dysfunction in
diabetic nephropathy, potentially influencing clinical practice and improving
patient outcomes.
Materials and Methods: 200 patients were randomly selected
and grouped into A, B, C, and D containing 50 patients in each group. Group A
and B had hypertensive patients with low and high protein diet given
respectively for 24 weeks. Group C and D had normotensive patients with low and
high protein diet given respectively for 24 weeks. 24 hours urinary albumin
(mg/day) excretion rate, Blood urea, Serum creatinine, Urine creatinine,
Creatinine clearance were estimated initially and at 24 weeks.
Results: The mean albuminuria in Group A dropped significantly from 1702±360.41
(baseline) to 1169±276.86 (24th week), with a p value of less than 0.0001. With
a p-value of less than 0.0001, the mean albuminuria in Group B increased significantly
from 1706±251.44 (baseline) to 2023±301.50 (24th week). The mean albuminuria in
Group C dropped significantly from 1279.80±178.62 (baseline) to 826.60±186.39
(24th week), with a p value <0.0001. With a p-value of less than 0.0001, the
mean albuminuria in Group D increased significantly from 1288.6±101.01
(baseline) to 1484±151.6 (24th week).
Conclusion: Patients with diabetic nephropathy benefit generally from dietary
protein restriction. The impact is most likely the result of enhanced glomerular
permeability and selectivity and is unaffected by variations in blood pressure
or blood glucose.
Author(s) Details:
Jyoti Prakash,
Department of General Medicine, AIIMS, Patna, India.
Please see the link here: https://stm.bookpi.org/ANUMS-V9/article/view/13625
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