Effect of Dietary Protein Restriction on Prognosis in Patients With Diabetic Nephropathy

NCT ID: NCT01521910

Last Updated: 2012-01-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

82 participants

Study Classification

INTERVENTIONAL

Study Start Date

1995-04-30

Study Completion Date

2000-06-30

Brief Summary

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The purpose of the investigators study was to determine the effect of dietary protein restriction on survival and progression to end stage renal disease (ESRD) in diabetic nephropathy.

Detailed Description

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The study was a prospective, randomized, unmasked, controlled trial carried out at the Steno Diabetes Center. With concealed randomization the patients were (in blocks of two according to the level of GFR) assigned to receive either a usual-protein diet or a low-protein diet.

After randomization an iso-caloric low-protein diet of 0.6 g/kg/day was prescribed to patients in the low-protein diet group. The usual-pro tein diet consisted of the patients' pre-study diet.

The planned duration of follow-up was four years, scheduled visits every three-months. All patients gave complete history of medication, underwent examination of weight, urinary albumin-, sodium- and urea excretion, serum albumin, serum urea, hemoglobin, hemoglobin A1c, blood pressure, serum total-cholesterol, high-density lipoprotein (HDL) cholesterol.

GFR, serum triglycerides,calcium and phosphorous, anthropometric measurements, nutritional status and smoking habits were evaluated every six months.

Dietary protein intake was estimated on the basis of three consecutive 24-hour urine samples completed before each visit, using urinary excretion of urea nitrogen.

GFR was measured by plasma clearance of 51Cr-EDTA over a 4 hour period and standardized for 1.73m2 body surface area using the same surface for each patient during the study.

Conditions

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Type 1 Diabetes Mellitus With Diabetic Nephropathy

Keywords

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survival protein restriction diabetic nephropathy type 1 diabetes GFR ESRD progressive renal disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Low protein diet

Group Type EXPERIMENTAL

low protein diet

Intervention Type DIETARY_SUPPLEMENT

An iso-caloric low protein diet of 0.6 g/kg/day was prescribed during the whole study duration.

The same dietician gave nutritional advices at least every three months during the whole study period. Patients were also seen by the same doctor during each visit for the whole study period.

Supplementation of Calcium of 500mg/day.

Urine albumin losses \>= 2 g/day wre replaced by increasing dietary protein on a gram-for-gram basis, only if the patient was compliant with the prescribed low-protein diet.

Normal protein diet

Group Type ACTIVE_COMPARATOR

normal protein diet

Intervention Type DIETARY_SUPPLEMENT

The patients pre-study diet during the whole study period

Patients were also seen by the same doctor during each visit for the whole study period.

Interventions

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low protein diet

An iso-caloric low protein diet of 0.6 g/kg/day was prescribed during the whole study duration.

The same dietician gave nutritional advices at least every three months during the whole study period. Patients were also seen by the same doctor during each visit for the whole study period.

Supplementation of Calcium of 500mg/day.

Urine albumin losses \>= 2 g/day wre replaced by increasing dietary protein on a gram-for-gram basis, only if the patient was compliant with the prescribed low-protein diet.

Intervention Type DIETARY_SUPPLEMENT

normal protein diet

The patients pre-study diet during the whole study period

Patients were also seen by the same doctor during each visit for the whole study period.

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Diabetes mellitus type 1
* duration at least 10 years
* onset before age of 35,
* presence of diabetic retinopathy
* albuminuria\>=300mg/24 h in at least 2/3 sterile urine samples
* no clinical or laboratory evidence of other kidney or urinary tract disease
* GFR above 20mL/min/1.73M2
* pre-study decline in GFR\>= 2 mL/min/year

Exclusion Criteria

* pregnancy
* history of congestive heart failure or myocardial infarction or coronary bypass surgery within the last three months
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Steno Diabetes Center Copenhagen

OTHER

Sponsor Role lead

Responsible Party

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Peter Rossing

Chief physician and Director of Research

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Henrik P Hansen, MD

Role: PRINCIPAL_INVESTIGATOR

Steno Diabetes Center Copenhagen

Locations

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Steno Diabetes Center

Gentofte Municipality, Gentofte, Denmark

Site Status

Countries

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Denmark

Other Identifiers

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Low Protein Diet

Identifier Type: -

Identifier Source: org_study_id