Otoda Toshiki, Kanasaki Keizo, Koya Daisuke
Department of Diabetology & Endocrinology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 920-0293, Japan.
Curr Diab Rep. 2014;14(9):523. doi: 10.1007/s11892-014-0523-z.
Diabetic nephropathy is the leading cause of progressive kidney disease, leading to end-stage renal disease and renal replacement therapy. Angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers have been considered effective at slowing the progression of kidney function deterioration. However, these drugs cannot sufficiently halt the progression of nephropathy to the extent that is required. A low-protein diet (LPD) is believed to be a nutritional intervention that may slow kidney disease progression. In fact, preclinical animal experiments have demonstrated excellent renoprotective effects of an LPD. However, in human clinical trials, analyses of the effects of protein restriction on diabetic nephropathy have not yet revealed consistently positive outcomes of this nutritional intervention. In this review, we analyze the potential renoprotective effects of an LPD on diabetic nephropathy and summarize the outcomes of clinical trials that have systematically investigated the efficacy of an LPD in diabetic nephropathy. In addition, we discuss some potential approaches associated with nutritional interventions to combat progressive kidney disease.
糖尿病肾病是进行性肾脏疾病的主要原因，可导致终末期肾病和肾脏替代治疗。血管紧张素转换酶抑制剂和/或血管紧张素受体阻滞剂被认为在减缓肾功能恶化进程方面有效。然而，这些药物无法充分阻止肾病发展到所需的程度。低蛋白饮食（LPD）被认为是一种可能减缓肾病进展的营养干预措施。事实上，临床前动物实验已证明LPD具有出色的肾脏保护作用。然而，在人体临床试验中，对蛋白质限制对糖尿病肾病影响的分析尚未 consistently 显示出这种营养干预的积极结果。在本综述中，我们分析了LPD对糖尿病肾病的潜在肾脏保护作用，并总结了系统研究LPD在糖尿病肾病中疗效的临床试验结果。此外，我们讨论了一些与营养干预相关的潜在方法，以对抗进行性肾脏疾病。 （注：原文中“consistently”未准确翻译，此处保留英文，可能是想表达“一直、始终”等意思，可根据实际情况调整）
