Impact of Low-Protein Dietary Intervention on Albuminuria in Diabetic Nephropathy: A Clinical Trial

Abstract

Diabetic Nephropathy (DN) represents one of the leading causes of end-stage renal disease (ESRD) and imposes a substantial clinical and economic burden. Microalbuminuria, recognized as an early marker of DN, is associated with heightened cardiovascular risk. While renin-angiotensin system inhibition and glycemic control are the strategies now, the role of a low-protein diet (LPD) in modulating DN and associated metabolic derangements remains under debate. This study assessed the impact of LPD on kidney function and metabolic indicators in type II diabetic patients and recently diagnosed with albuminuria. An 11-month prospective, randomized, controlled study that enrolled 80 patients suffering from type II diabetes and recently diagnosed with albuminuria. Participants were randomized into three groups: ACE-I/ARB, LPD (0.6 g/kg/day), and LPD + ACE-I/ARB groups. In this study, we evaluated renal function (GFR, UAER), glycemic controls (FBS, HbA1c), and metabolic indicators (BMI, blood pressure, lipid profile) at the start and conclusion of the study. All study groups showed a significant reduction in albuminuria (p< 0.05) in the within-group comparison. Meanwhile, group comparison showed no statistical variation in UAER. Furthermore, GFR showed improvement in the LPD group, but it wasn’t statistically significant. Moreover, the LPD group showed significant reductions in FBS, HbA1C, LDL, T.G, systolic blood pressure, and BMI (all p < 0.05); these effects weren’t observed in other groups. LPD in type II diabetes effectively reduces albuminuria in comparison to ACE-I/ARB therapy. Moreover, LPD shows significant benefits regarding glycemic control, lipid profile, and body weight. These results suggest that the therapeutic potential of LPD to manage diabetic nephropathy and its metabolic complications highlights the critical role of dietary management.