| BackgroundDiabetic kidney disease (DKD) is a common complication of diabetes and also a leading cause of end-stage renal disease(ESRD).But the risk factors of diabetic nephropathy is complexity,which has not yet fully understood, and current therapies of DKD is much less. Generally speaking, when the patients of type 2 diabetic diagnose diabete, they maybe have microalbuminuria, urine protein or even positive. If microalbuminuria appears, not only marked the presence of early diabetic nephropathy, but also greatly increased the prevalence of cardiovascular disease and mortality risk, so doctors should be highly valued. Some studies suggest that low salt and low protein diet of diabetic can delay renal function deterioration of diabetes. But there are also reports of low protein diabetic diet that not only can not delay the deterioration of renal function, but also can lead to malnutrition, poor security.Therefore, whether low salt and low protein diet of diabetes can delay the renal function deterioration and can lead to malnutrition is still the pure purpose in the controversy.ObjectiveEvaluate the short-term efficacy and safety of low salt and low protein diet in diabetes.MethodsThe study performed randomization principles. A total of 42 patients with DKD were divided into tow groups:low salt and low protein diabetic diet and diabetes diet group. Patients were accordance with the principles of diet intervention in stric, and they were given enough calorie (30-35 kcal/kg/d). Inclusion criteries included the following sides. The number one is the patients who were no more than 80 years of age, not sex limitation; the second is the patients who diagnosed with type 2 diabetes; the third is the patients who were UAER>200μg/min (300-500mg/d), or urinary protein excretion>0.5g/24h, and the non-selective proteinuria according to Mogensen staging criteria; the forth is the patients who positive urine protein appeared that was the 24-hour urine protein more than 0.3 g; the fifth is the patients who were application of RAS system inhibitor (ACEI or ARB drugs), stable over 4 weeks after continuous application of pressure not higher than150/90mmHg; the sixth is the patients with diabetic nephropathy who fundus changed; the seventh is the patients who were not yet started dialysis treatment; the eighth is the patients who understood the whole process of experiment, voluntary participation and signed informed consent.The outcome measures the changes in blood 24 hours urea nitrogen,24-hour urinary sodium,24-hour urinary protein, eGFR, serum creatinine, blood urea nitrogen and serum albumin before and after treatment. The patients should be tested at the time of admission, then clinical assessment once again after 10-15 days.ResultsExperimental group and control group comparied before and after treatment:a downward trend of creatinine compared with that before the treatment and a upward trend of eGFR compared with that before the treatment, no significant difference (P> 0.05). The experimental group significantly decreased after treatment, blood urea nitrogen, with significant difference (P<0.05). The control group before and after treatment have no significant difference in blood urea nitrogen (P> 0.05). Experimental group after treatment,24 hours of urinary protein excretion compared with before treatment significantly decreased, with statistical difference (P<0.05). Serum albumin remained stable before and after treatment, the difference was not statistically significant (P> 0.05).ConclusionBy observing the low salt and low protein diabetic diet, the urea nitrogen and urinary protein decreased significantly. The diet intervention is safety and well tolerated. And it can maintain the nutritional status of patients with DKD. It also can delay the deterioration of renal function. However, before and after the treatment, all the parameters between the two groups had no statistically significant differences. So a long time study is still needed.
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