Dietary interventions to contrast the onset and progression of diabetic nephropathy: A critical survey of new data

ABSTRACT

This article is a critical overview of recent contributions on the dietary corrections and the foods that have been claimed to delay or hinder the onset of diabetic nephropathy (DN) and its progression to end-stage renal disease. Innovative dietary and behavioral approaches to the prevention and therapy of DN appear to be the most captivating in consideration of the rather well-established protocols for glucose and blood pressure control in use. In addition to restricted caloric intake to contrast obesity and the metabolic syndrome, adjustments in the patient's macronutrients intake, and in particular some degree of reduction in protein, have been long considered in the prevention of DN progression. More recently, the focus has shifted to the source of proteins and the content of glycotoxins in the diet as well as to the role of specific micronutrients. Few clinical trials have specifically addressed the role of those micronutrients associated with diet proteins that show the most protective effect against DN. Research on clinical outcome and mechanisms of action of such micronutrients appears the most promising in order to develop both effective intervention on nutritional education of the patient and selection of functional foods capable of contrasting the onset and progression of DN.

KEYWORDS:

• Diabetes mellitus
• nephropathy
• diet
• protein intake
• advanced glycation end-products (AGEs)
• inflammation

Conflicts of interest

None.

Funding

This article was funded by Sapienza University of Rome (“Progetto Ateneo 2013”) to S.M.

Author contributions

S.M. and C.P. conceived the study, performed a systematic literature search for records to be included in the review and drafted the article. C.I. and G.P. revised the article critically and suggested pertinent changes. All Authors have approved the final article.