Dietary Protein Intake and Kidney Disease in Type 2 Diabetes: A Narrative Review

Xue Li; Rui  Lan; Xiangjun Chen

Authors

Xue Li Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Rui Lan Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Xiangjun Chen Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

Keywords:

Dietary protein intake, Type 2 diabetes mellitus, Chronic kidney disease, Renal disease progression

Abstract

Traditionally, low-protein diet (LPD) is considered an important treatment for chronic kidney disease (CKD), while high-protein diet (HPD) is deemed to exacerbate the progression of CKD. Target dietary protein intake (DPI) for people with diabetes and CKD stages 1-4 should be 0.8 g/kg per day by current guidelines, neither HPD nor LPD appears beneficial. However, data from the NHANES show that the current actually average consumption of protein in the United States is higher than the guidelines recommended amount. We reviewed the current evidences on the relationship between protein intake and renal disease in Type 2 diabetes mellitus (T2DM) patients with different renal function stages and found that in T2DM patients with CKD stages 1-2, HPD was not associated with the risk of renal disease progression, and LPD did not benefit for these patients. Therefore, perhaps we should not emphasize the importance of dietary protein intake intervention in patients with CKD stages 1-2. Besides, LPD may alleviate proteinuria in patients with CKD stages 3-5, despite the risk of malnutrition. This narrow review focuses on the potential consequences of HPD or LPD on kidney diseases, and it may provide a guidance for clinicians to manage protein intake when treating T2DM patients with different stages of CKD.

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