{"title":"日本成年糖尿病肾病患者在不同饮食疗法(包括能量限制饮食和低碳水化合物饮食)下的肾功能轨迹:一项回顾性队列研究","authors":"Tomomi Shirai, Sakiko Inaba, Miyu Maemura, Maki Saho, Miyu Sato, Mariko Sanada, Yoko Tsukamoto, Gaku Inoue, Taichi Nagahisa, Shinichi Tanaka, Hajime Tanaka, Hideaki Kurata, Takeshi Katsuki, Toshihide Kawai, Satoru Yamada","doi":"10.1007/s13340-025-00808-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Recently, the Japan Diabetes Society changed its nutrition recommendations and now recognizes a low-carbohydrate diet as an effective dietary approach. There has been controversy regarding low-carbohydrate diets in relation to renal function. That is, high protein intake may lead to renal damage through hyperfiltration. Global nutritional therapy for diabetic kidney disease (DKD) recommends a protein intake of 0.8 g/kg body weight (BW)/day. In Japan, the recommended protein intake is precisely determined based on the chronic kidney disease stage. However, evidence supporting the positive health impact of such protein restriction is scarce. Therefore, we aimed to investigate the effect of a low-carbohydrate diet without protein restriction on the estimated glomerular filtration rate (eGFR) decline rate.</p><p><strong>Methods: </strong>Clinical data of patients with DKD in Tokyo Saiseikai Central Hospital and Kitasato Institute Hospital in Japan were retrospectively analyzed between February 2019 and December 2023. Sixty-eight participants were classified into two groups based on their diet: the energy-restricted and low-carbohydrate groups.</p><p><strong>Results: </strong>The protein intake of the low-carbohydrate group was significantly higher than that of the energy-restricted group (1.2 ± 0.4 and 1.0 ± 0.2 g/kg BW/day, respectively). No significant differences were observed in the baseline, endpoint, or slope of eGFR between the two groups.</p><p><strong>Conclusions: </strong>This study suggests that among Japanese adults with DKD, the protein intake difference between energy-restricted and low-carbohydrate diets does not form any gap in eGFR decline rates.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13340-025-00808-y.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"16 3","pages":"493-503"},"PeriodicalIF":1.2000,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209081/pdf/","citationCount":"0","resultStr":"{\"title\":\"Renal function trajectories of Japanese adults with diabetic kidney disease on different diet therapies including energy-restricted and low-carbohydrate diets: a retrospective cohort study.\",\"authors\":\"Tomomi Shirai, Sakiko Inaba, Miyu Maemura, Maki Saho, Miyu Sato, Mariko Sanada, Yoko Tsukamoto, Gaku Inoue, Taichi Nagahisa, Shinichi Tanaka, Hajime Tanaka, Hideaki Kurata, Takeshi Katsuki, Toshihide Kawai, Satoru Yamada\",\"doi\":\"10.1007/s13340-025-00808-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Recently, the Japan Diabetes Society changed its nutrition recommendations and now recognizes a low-carbohydrate diet as an effective dietary approach. There has been controversy regarding low-carbohydrate diets in relation to renal function. That is, high protein intake may lead to renal damage through hyperfiltration. Global nutritional therapy for diabetic kidney disease (DKD) recommends a protein intake of 0.8 g/kg body weight (BW)/day. In Japan, the recommended protein intake is precisely determined based on the chronic kidney disease stage. However, evidence supporting the positive health impact of such protein restriction is scarce. Therefore, we aimed to investigate the effect of a low-carbohydrate diet without protein restriction on the estimated glomerular filtration rate (eGFR) decline rate.</p><p><strong>Methods: </strong>Clinical data of patients with DKD in Tokyo Saiseikai Central Hospital and Kitasato Institute Hospital in Japan were retrospectively analyzed between February 2019 and December 2023. Sixty-eight participants were classified into two groups based on their diet: the energy-restricted and low-carbohydrate groups.</p><p><strong>Results: </strong>The protein intake of the low-carbohydrate group was significantly higher than that of the energy-restricted group (1.2 ± 0.4 and 1.0 ± 0.2 g/kg BW/day, respectively). No significant differences were observed in the baseline, endpoint, or slope of eGFR between the two groups.</p><p><strong>Conclusions: </strong>This study suggests that among Japanese adults with DKD, the protein intake difference between energy-restricted and low-carbohydrate diets does not form any gap in eGFR decline rates.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13340-025-00808-y.</p>\",\"PeriodicalId\":11340,\"journal\":{\"name\":\"Diabetology International\",\"volume\":\"16 3\",\"pages\":\"493-503\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2025-03-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209081/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetology International\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s13340-025-00808-y\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/7/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetology International","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s13340-025-00808-y","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Renal function trajectories of Japanese adults with diabetic kidney disease on different diet therapies including energy-restricted and low-carbohydrate diets: a retrospective cohort study.
Objective: Recently, the Japan Diabetes Society changed its nutrition recommendations and now recognizes a low-carbohydrate diet as an effective dietary approach. There has been controversy regarding low-carbohydrate diets in relation to renal function. That is, high protein intake may lead to renal damage through hyperfiltration. Global nutritional therapy for diabetic kidney disease (DKD) recommends a protein intake of 0.8 g/kg body weight (BW)/day. In Japan, the recommended protein intake is precisely determined based on the chronic kidney disease stage. However, evidence supporting the positive health impact of such protein restriction is scarce. Therefore, we aimed to investigate the effect of a low-carbohydrate diet without protein restriction on the estimated glomerular filtration rate (eGFR) decline rate.
Methods: Clinical data of patients with DKD in Tokyo Saiseikai Central Hospital and Kitasato Institute Hospital in Japan were retrospectively analyzed between February 2019 and December 2023. Sixty-eight participants were classified into two groups based on their diet: the energy-restricted and low-carbohydrate groups.
Results: The protein intake of the low-carbohydrate group was significantly higher than that of the energy-restricted group (1.2 ± 0.4 and 1.0 ± 0.2 g/kg BW/day, respectively). No significant differences were observed in the baseline, endpoint, or slope of eGFR between the two groups.
Conclusions: This study suggests that among Japanese adults with DKD, the protein intake difference between energy-restricted and low-carbohydrate diets does not form any gap in eGFR decline rates.
Supplementary information: The online version contains supplementary material available at 10.1007/s13340-025-00808-y.
期刊介绍:
Diabetology International, the official journal of the Japan Diabetes Society, publishes original research articles about experimental research and clinical studies in diabetes and related areas. The journal also presents editorials, reviews, commentaries, reports of expert committees, and case reports on any aspect of diabetes. Diabetology International welcomes submissions from researchers, clinicians, and health professionals throughout the world who are interested in research, treatment, and care of patients with diabetes. All manuscripts are peer-reviewed to assure that high-quality information in the field of diabetes is made available to readers. Manuscripts are reviewed with due respect for the author''s confidentiality. At the same time, reviewers also have rights to confidentiality, which are respected by the editors. The journal follows a single-blind review procedure, where the reviewers are aware of the names and affiliations of the authors, but the reviewer reports provided to authors are anonymous. Single-blind peer review is the traditional model of peer review that many reviewers are comfortable with, and it facilitates a dispassionate critique of a manuscript.