Abstract
Since Jan 1993 we have been investigating the effect of restriction of dietary protein on progression of the nephrotic syndrome in seven consecutive nephrotic inpatients with non-insulin-dependent diabetes mellitus(NIDDM)(restriction of dietary protein group, group R). All of the patients were assigned a low protein diet(0.7g/kg of IBW/day). For comparison with group R, five other consecutive inpatients were chosen as a control group(group C) based on medical records before Dec 1992. All baseline clinical characteristics of renal disease in the two groups were comparable. The amounts of protein given were 0.70±0.05g/kg in group R and 1.24±0.28g/kg of IBW/day in group C(mean±SD, P<0.001), respectively.
In group R, edema improved with medical treatment within one month in all patients. After institution of diet-therapy, only two patients changed hospitals for dialysis, one, who had advanced end-stage renal disease, at 3 months, and the other, whose compliance with dietary therapy became poor after discharge, at 9 months. In group C, on the other hand, nephrosis deteriorated in four of the five patients. In all four patients, renal failure rapidly progressed and required hemodialysis within 6 months after institution of therapy.
In conclution, a low protein diet(in this study, average 0.7g/kg of IBW/day) can ameliorate not only the nophrotic syndrome but the clinical course of renal failure in nephrotic patients with NIDDM.
