Effect of Dietary Management on Albuminuria and Renal Markers in Cases of Diabetic Nephropathy

Diabetes mellitus (DM) involves cardiovascular, renal, neurological, ocular, gastrointestinal tract, genitourinary, dermatological systems. Diabetic Nephropathy is a persistent proteinuria of >500mg/day with concomitant retinopathy & hypertension. This study was done to assess the effect of dietary protein restriction as a non pharmacological approach on albuminuria and renal markers in patients of diabetic Nephropathy.

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.

In Group A mean albuminuria has decreased from 1702±360.41 (at baseline) to 1169±276.86 (at 24^th week) with p value < 0.0001 that decrease was extremely significant. In Group B mean albuminuria has increased from 1706±251.44 (at baseline) to 2023±301.50 (at 24^th week) with p value < 0.0001 that increase was extremely significant. In Group C, mean albuminuria has decreased from 1279.80±178.62 (at baseline) to 826.60±186.39 (at 24^th week) with p value < 0.0001 that decrease was extremely significant. In Group D mean albuminuria has increased from 1288.6±101.01 (at baseline) to 1484±151.6 (at 24^th week) with p value < 0.0001 that increase was extremely significant.

Dietary protein restriction has overall beneficial effect on patients of diabetic nephropathy. The effect is independent of blood glucose and blood pressure changes and is due to improved glomerular permeability and selectivity probably.