Complementary Medicine/Articles

Protein Intake, Diabetes and Kidney Function

 One of the complications of diabetes leading to kidney failure is nephropathy. It is caused by poor blood sugar control over time damaging blood vessels and the filtering mechanism of the kidneys. It is not caused by eating protein. This condition often progresses to end-stage renal failure regardless of treatment.

 Although healthy people are often cautioned against eating a higher protein intake to protect their kidneys this caveat is not supported by research.¹ 

Protein and Diabetes

People with diabetes are often recommended to limit protein intake to protect their kidneys. Since fat is also limited that leaves a dietary intake of high carbohydrates: the very foods that elevate blood sugar the most. Since a majority of people with diabetes do not develop nephropathy wouldn’t it make more sense to recommend more protein to replace carbs especially the high glycemic carbs? Protein has also been found to control hunger which can lead to a more moderate calorie intake. This simple strategy can be very helpful to many overweight diabetics trying to manage their weight while going a long way to improve blood sugar control.

 Research published in Diabetes Care has shown that dietary intake of protein is not related to clinical protein in the urine in type 2 diabetics who do not take insulin. The head researcher concluded that “These data do not support the hypothesis that high-protein intake is a risk factor for clinical proteinuria… Any recommendation for protein restriction…before the development of NIDDM related nephropathy must be made with caution.”² Additionally, compliance with a severe protein restriction is difficult long term.

 Interestingly, a case report recently published in a patient with long standing diabetic nephropathy showed improvement in kidney function using a low carbohydrate diet. This supports the clinical observations of other practitioners using a low carb regimen. By improving blood sugar control, managing weight and blood pressure, kidney function may improve without protein restriction. ³ Of course any dietary changes must be discussed with your physician and kidney function routinely monitored.

 Severe protein restriction even in people with severe nephropathy can led to malnutrition and does not slow the progression of the disease.⁴

 The key to prevent or slow the development of any of the complications of diabetes remains maintaining the best blood sugar control possible. Each person needs to find the dietary approach that they can follow for a lifetime. Because of its ability to dramatically improve glycemic control a low carb regimen can definitely be a viable choice.

 Facts about Diabetic Nephropathy:

Occurs in about 30% of people with type 2 diabetes.

Genetics may play a role.

Leading cause of kidney failure in the U.S.

Increased risk with high blood pressure.

Increased risk in diabetic Native-Americans, African-Americans

  and Hispanics especially of Mexican descent.

Smoking is a contributing factor.

References:

1. Martin, W., Armstrong, L., et al, “Dietary protein intake and renal function”, Nutrition & Metabolism, 2005, 2:25.
2. Jameel, N., Pugh, J., et al., “Dietary Protein Intake is Not Correlated with Clinical Proteinuria in NIDDM”, Diabetes Care, 1992, 15:2. 178-183.
3. Nielsen, J., et al., “A low-carbohydrate diet may prevent end-stage renal failure in type 2 diabetes. A case report”, Nutrition & Metabolism, 2006, 3:23.
4. Meloni, C., Morosetti, M., et al., “Severe Dietary Protein Restriction in Overt Diabetic Nephropathy: Benefits or Risks?” Journal of Renal Nutrition, April 2002, 12:2, 96-101.
   
    

This information is in no way intended as medical advice or as a substitute for medical treatment. This information should be used in conjunction with the guidance and care of your physician.