Association of Protein Intake Level with Progression of Renal Function Impairment and Prognosis in Diabetic Kidney Disease
[Objective]To investigate the relationship between different protein intake levels and the progression of renal function impairment in diabetic kidney disease(DKD)patients.[Method]A prospective cohort study was used to select patients with early DN for follow-up observation.Protein intake was assessed according to 24-hour urinary urea nitrogen monitoring 1 week before enrollment,and the 2020 Quality Recommendations for Renal Outcomes(KDOQI)criteria were used.There were 53 patients with early DN who met the low protein diet standard[protein intake 0.6-0.8 g/(kg·d)(low protein group)]and 54 patients with early DN who met the high protein diet standard[(protein intake>0.8 g/(kg·d)(high protein group)].Both groups were followed up for 12 months.The changes of renal func-tion and prognosis were compared.[Result]There was no significant difference in FPG,HbA1c,SBP,DBP,TG and TC levels between low protein group and high protein group(P>0.05).After 24 months of follow-up,there were no significant differences in FPG,HbA1c,SBP,DBP,TG and TC levels between the low protein group and the high protein group(P>0.05).There were no significant differences in BUN,Scr,24-hour urinary protein,ALB,blood uric acid and β2-MG levels between low protein group and high protein group at the time of enrollment(P>0.05).After 24 months of follow-up,BUN,Scr,24-hour urinary protein,blood uric acid and β2-MG levels in the low protein group were lower than those in the high protein group,with statistical significance(P<0.05).After 24 months of follow-up,7 patients in the low protein group had endpoint events,and 17 patients in the high protein group had endpoint events.The incidence of endpoint events in the low protein group was significantly lower than that in the high protein group(P<0.05).Survival analysis of the two groups showed that the survival time without disease progression was longer in the low protein group than in the high protein group(χ2=3.953,P=0.047<0.05).[Conclusion]For patients with early DKD,low-protein diet control intervention is beneficial to delay the progres-sion of renal injury and reduce the incidence of clinical DKD.
proteindiabetic kidney disease(DKD)renal function impairmentprognosisurea nitrogen
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