Papel da dieta como fator de risco e progressão da nefropatia diabética

Abstract

Diabetic nephropathy (DN) is the leading cause of kidney disease in patients starting renal replacement therapy, and affects up to 40% of type 1 and type 2 diabetic patients. Diet seems to play an important role in the development of the disease. There are evidences supporting the concept that not only the amount but also the origin of dietary protein are associated with DN. Few studies analyzed the role of dietary lipids. A low-protein diet slows down the decline of renal function and ameliorates the DN prognosis and death in patients with type 1 diabetes with micro- and macroalbuminuria. Studies in type 2 diabetic patients are scanty but short-term studies suggest that this approach decreases albuminuria. However, the use of low-protein diet for long periods is compromised by poor compliance and its long-term safety is not firmly established. Enthusiastic results come up when comparing the effect of different sources of animal protein on renal function and lipid profile in patients with DN, which may represent an alternative strategy for low-protein diet on medical nutritional therapy in patients with DN and in cardiovascular risk factors and endothelial function.

Diagnóstico de enfermagem Eliminação urinária prejudicada em pessoas com Diabetes Mellitus

“…As dietas hipoproteicas recomendadas modificam de forma favorável a evolução da ND reduzindo o risco de insuficiência renal crônica terminal ou morte em 76,0% dos casos (2) . No entanto, o seu uso contínuo é comprometido pela dificuldade de adesão à restrição protéica por tempo prolongado e pela sua segurança nutricional não estar ainda estabelecida (20) .…”