Papel dos lipídeos da dieta na nefropatia diabética

Almeida, Juliano Milanezi de; Mello, Vanessa D. de; Canani, Luís Henrique Santos; Gross, Jorge Luiz; Azevedo, Mirela Jobim de

doi:10.1590/s0004-27302009000500016

Cited by 7 publications

(4 citation statements)

References 60 publications

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“…The dietary components included in the second cluster have been associated with lipid profile 3,26 and renal function 27,28 in diabetes. The "dairy and saturated fatty acids" item is another component designed to determine the intake of low-fat or non-fat dairy products as recommended by the Dietary Approaches to Stop Hypertension (DASH) diet plan, which play a key role in reducing cardiovascular risk 29 .…”

Section: Discussionmentioning

confidence: 99%

Development of a Healthy Eating Index for patients with type 2 diabetes

et al. 2015

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Objective:This study sought to develop a dietary index for assessment of diet quality aiming for compliance with dietary recommendations for diabetes: The Diabetes Healthy Eating Index.Methods:Cross-sectional study with 201 outpatients with type 2 diabetes (61.4±9.7 years of age; 72.1% were overweight; 12.1±7.7 years of diagnosis; 7.3±1.3% mean HbA1c). Clinical and laboratory evaluations were performed together with 3-day weight diet records. The dietary index developed included 10 components: "diet variety", "fresh fruits", "vegetables", "carbohydrates and fiber sources", "meats and eggs", "dairy products and saturated fatty acids", "oils and fats", "total lipids", "cholesterol", and "transunsaturated fatty acids". The performance of each component was evaluated using the Item Response Theory, and diet quality was scored from 0-100%.Results:Overall, diet quality in this sample was 39.8±14.3% (95%CI=37.8-41.8%), and only 55 patients had a total diet quality score >50%. Good compliance was observed in only four index components: "total lipids", "variety", "fiber sources", and "dairy and saturated fatty acids". The components that differentiated patients with poor dietary quality from those with good dietary quality were "vegetables", "diet variety", "dairy and saturated fatty acids" and "total lipids". The greatest determinants of dietary quality were the components "diet variety", "vegetables", and "total lipids".Conclusion:This dietary index proposed assesses diet quality in compliance with the specific nutritional recommendations for diabetes. In clinical practice, this novel index may be a useful tool for the assessment and management of diet of patients with type 2 diabetes.

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Section: Discussionmentioning

confidence: 99%

Development of a Healthy Eating Index for patients with type 2 diabetes

et al. 2015

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“…As dislipidemias, que são consequentes da disfunção do metabolismo dos lipídeos, principalmente do colesterol total, HDL-colesterol, LDL-colesterol e triglicérides, aumentam o risco de os diabéticos desenvolverem proteinúria e lesão renal em longo prazo 22,23,24,25 . Essa hipótese é confirmada quando os níveis de triglicerídeos e colesterol elevam-se de maneira proporcional ao aumento da albuminúria 26 .…”

Section: Brazilian Journal Of Health Reviewunclassified

Nefropatia diabética - incidência e fatores de risco associados

Maciel

Vasconcelos

Andrade

2019

BJHR

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“…Despite optimal treatment with intensive glycemic control and inhibitors of the renin-angiotensin system (RAS), residual risk remains high, as shown in the STENO-2 trial (4). Glomerular hyperfiltration has long been proposed to be a major contributing factor in the pathogenesis of DKD ( 170) and numerous studies reported on the association between whole-kidney hyperfiltration and onset and progression of albuminuria (171)(172)(173). In contrast, large-sized studies that estimated GFR did not detect such an association, which may relate to definitions and methods of renal function measurement (174)(175)(176).…”

Section: Diabetic Kidney Disease: a Role For Impaired Glomerular Func...mentioning

confidence: 99%

“…Glomerular hyperfiltration has long been proposed to be a major contributing factor in the pathogenesis of DKD ( 170) and numerous studies reported on the association between whole-kidney hyperfiltration and onset and progression of albuminuria (171)(172)(173). While glomerular hyperfiltration is often referred to as elevated whole-kidney GFR, the number of functioning nephrons should also be taken into account, especially in elderly people with T2D (177).…”

Section: Combination Therapy Of Sglt2 Inhibition and Ras Inhibition: ...mentioning

confidence: 99%

SGLT2 inhibitors: Salty or Just Sweet?

Scholtes

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• Dapagliflozin lowers blood pressure without clear effects on sodium excretion in people with T2D and preserved kidney function • Dapagliflozin did not induce prolonged changes in plasma volume, extracellular volume, and intracellular volume • Other nondiuretic-related effects cannot be ruled out in the CV protective effects conferred by SGLT2 inhibitors, including reductions in arterial stiffness, inhibition of the sympathetic nervous system, or restoration of endothelial function. • Multiple intra-kidney compensatory mechanisms are activated to counteract dapagliflozin-induced osmotic diuresis, including 1) an increase in co-peptin 2) decrease in free water clearance that facilitate maintenance of normal urinary volumes 3) a decrease in fractional urea excretion and 4) activation of RAS. • Dapagliflozin decreased blood pressure despite no clear changes in 24-hr sodium and volume excretion in patients with CKD without T2D. • Dapagliflozin activates kidney specific adaptive mechanisms to maintain body fluid and sodium balance to prevent volume depletion, including activation of RAS and stimulation of ADH release, in patients with CKD without T2D. • Kidney-active drugs do not seem to alter the effect of SGLT2 inhibitors on hard kidney endpoints in large outcome trials. • Dapagliflozin over 24 weeks provides similar clinically relevant improvements in urinary albumin- creatinine ratio (UACR), eGFR, HbA1c, and hematocrit, irrespective of treatment with RAS inhibitors at baseline, in people with T2D and increased albuminuria. • The use of RAS inhibitors in combination with SGLT2 inhibitors does not impact the biomarkers associated with CV and kidney function. • Empagliflozin+losartan combination therapy induced a greater placebo-controlled reduction in mGFR and estimated glomerular pressure compared to either of the agents alone. • This reduction in mGFR was accompanied by a trend towards a reduction in renal vascular resistance (RVR), suggesting that the clinically observed mGFR decline may be explained by postglomerular vasodilation. • These data support combined beneficial effects of RAS and SGLT2 inhibitors. • Empagliflozin+losartan combination therapy has a larger blood pressure-lowering effect than either of the agents alone when compared to placebo. • Both drugs lower blood pressure by reductions in arterial stiffness and sympathetic nervous system (SNS) activity • The mechanisms underlying the blood pressure reductions at least partially differ between empagliflozin and losartan, since empagliflozin additionally seems to induce volume contraction.

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Papel dos lipídeos da dieta na nefropatia diabética

Cited by 7 publications

References 60 publications

Development of a Healthy Eating Index for patients with type 2 diabetes

Development of a Healthy Eating Index for patients with type 2 diabetes

Nefropatia diabética - incidência e fatores de risco associados

SGLT2 inhibitors: Salty or Just Sweet?

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