J Korean Diabetes.  2021 Mar;22(1):51-55. 10.4093/jkd.2021.22.1.51.

Clinical Nutrition Therapy of Diabetic Nephropathy

• Park S

• KMID: 2526180
• DOI: http://doi.org/10.4093/jkd.2021.22.1.51

Abstract

Diabetic nephropathy is a microvascular complication in diabetic patients and a major cause of endstage kidney disease. Proper blood sugar control and blood pressure management can delay progression of kidney disease and can be aided by appropriate clinical nutritional therapy. As excessive protein intake affects kidney function and albuminuria, it is necessary to control protein intake. In addition, restriction of sodium intake is required as it can reduce blood pressure and albuminuria and delay the progression of kidney disease. For potassium and phosphorus, though a specific intake is not recommended, adjustments might be needed depending on stage of kidney disease and blood levels.

Keyword

Diabetic nephropathies; Nutrition therapy

Reference

1. American Diabetes Association. 11. Microvascular complications and foot care: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020. 43(Suppl 1):S135–51.

2. American Diabetes Association. Diabetic nephropathy. Diabetes Care. 2003. 26(Suppl 1):S94–8.

3. The Korean Society of Nephrology. Guideline for prevention and management of chronic kidney disease for primary care provider physician. Seoul: The Korean Society of Nephrology;2013. p. 58–127.

4. Korean Diabetes Association. Treatment guideline for diabetes. 6th ed.Seoul: Korean Diabetes Association;2019. 33–121.

5. Fox CS., Matsushita K., Woodward M., Bilo HJ., Chalmers J., Heerspink HJ, et al. Chronic Kidney Disease Prognosis Consortium. Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis. Lancet. 2012. 380:1662–73.

6. Kidney Disease Outcomes Quality Initiative. KDOQI clinical practice guidelines and clinical practice recommendations for diabetes and chronic kidney disease. Am J Kidney Dis. 2007. 49(2 Suppl 2):S12–154.

7. Diabetes Control and Complications Trial Research Group. Nathan DM., Genuth S., Lachin J., Cleary P., Crofford O, et al. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993. 329:977–86.

8. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998. 352:837–53.

9. Wang Y., Chen X., Song Y., Caballero B., Cheskin LJ. Association between obesity and kidney disease: a systematic review and meta-analysis. Kidney Int. 2008. 73:19–33.

10. Korean Society for the Study of Obesity. Guideline for the management of obesity in Korea. Seoul: Korean Society for the Study of Obesity;2018. p. 69–82.

11. Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. KDIGO 2020 Clinical practice guideline for diabetes management in chronic kidney disease. Kidney Int. 2020. 98(4S):S1–115.

12. Yuzbashian E., Asghari G., Mirmiran P., Hosseini FS., Azizi F. Associations of dietary macronutrients with glomerular filtration rate and kidney dysfunction: Tehran lipid and glucose study. J Nephrol. 2015. 28:173–80.

13. Oosterwijk MM., Soedamah-Muthu SS., Geleijnse JM., Bakker SJL., Navis G., Binnenmars SH, et al. High dietary intake of vegetable protein is associated with lower prevalence of renal function impairment: results of the Dutch DIALECT-1 Cohort. Kidney Int Rep. 2019. 4:710–9.

14. Committee of Clinical Practice Guideline of the Korean Society of Lipid and Atherosclerosis. Korean guidelines for the management of dyslipidemia. 4th ed.Seoul: The Korean Society of Lipid and Atherosclerosis;2018. p. 49–65.

15. Shapiro H., Theilla M., Attal-Singer J., Singer P. Effects of polyunsaturated fatty acid consumption in diabetic nephropathy. Nat Rev Nephrol. 2011. 7:110–21.

16. de Souza RJ., Mente A., Maroleanu A., Cozma AI., Ha V., Kishibe T, et al. Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. BMJ. 2015. 351:h3978.

17. Suckling RJ., He FJ., Macgregor GA. Altered dietary salt intake for preventing and treating diabetic kidney disease. Cochrane Database Syst Rev. 2010. (12):CD006763.

18. Ikizler TA., Burrowes JD., Byham-Gray LD., Campbell KL., Carrero JJ., Chan W, et al. KDOQI Clinical practice guideline for nutrition in CKD: 2020 update. Am J Kidney Dis. 2020. 76(3 Suppl 1):S1–107.