chronic kidney disease

A recently published study investigated whether low-protein diets are nutritionally safe for individuals with diabetes and chronic kidney disease.

Chronic kidney disease has become increasingly common over the past few decades. Dialysis, a treatment that removes excess water and waste from the blood, can temporarily help patients that have kidney failure, but this is a very expensive and burdensome procedure. Reports show that dialysis significantly decreases the quality of life for many patients. Therefore, health professionals and scientists have been searching for more conservative and less invasive measures that can help patients with chronic kidney disease before they progress to end-stage renal disease and require dialysis.

Nutrition and food intake can largely influence the kidneys since they are responsible for filtering waste products from the blood. Notably, the metabolism of proteins can adversely affect chronic kidney disease. Low-protein diets are often prescribed as a mechanism to prevent kidney disease and symptoms of kidney disease. However, low-protein diets can sometimes lead to a lack of nutrients and energy.

Another point of consideration is the presence of diabetes in patients with chronic kidney disease since these two conditions often occur together. The biology behind diabetes may exacerbate the potential side-effects of a low-protein diet. To investigate this concern, a group from Italy conducted a clinical trial in which chronic kidney disease patients with or without diabetes were placed on a low-protein diet. They published their findings in BMC Nephrology.

Low-protein diet improves diabetes and blood urea levels

They enrolled 197 chronic kidney disease patients in this study, including 81 who also had diabetes. They selected some patients to undergo a low-protein diet supplemented with ketoacids, along with nutritional consultation and dietician support. These patients underwent at least six months of the diet, and the researchers made clinical observations at multiple time points.

They observed that the low-protein diet could lower resting blood sugar levels in patients that had diabetes and chronic kidney disease. Furthermore, levels of blood urea, a type of waste product that is normally filtered out through the kidneys, significantly decreased in diabetic and non-diabetic patients who were on the diet. Lastly, the authors of this study observed that there was a sudden decline in body weight, without affecting muscle mass or fitness, which was maintained throughout the study period as a result of the diet.

Safe and effective for diabetic chronic kidney disease patients

Overall, this study found that the low-protein diet, administered by a professional dietician, is safe in patients with diabetic chronic kidney disease in terms of their nutritional status. Moreover, the diet provides beneficial impacts, such as a lower body weight and a reduced accumulation of waste products in the blood, in both diabetic and nondiabetic patients.

The data from this study support the prescription of a low-protein diet for diabetic chronic kidney disease patients as a conservative measure to improve patient outcomes and to avoid the necessity for cumbersome procedures like dialysis.

Written by Branson Chen, BHSc

Reference: Bellizzi V, Calella P, Hernández JN, González VF, Lira SM, Torraca S, Arronte RU, Cirillo P, Minutolo R, Cárdenas RA. Safety and effectiveness of low-protein diet supplemented with ketoacids in diabetic patients with chronic kidney disease. BMC Nephrology. 2018 Dec;19(1):110.

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