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Dietary Fiber Intake (Supplemental or Dietary Pattern Rich in Fiber) and Diabetic Kidney Disease: A Systematic Review of Clinical Trials

Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos 2350, Prédio 12, 4º andar, Porto Alegre-RS 90035-003, Brazil
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Author to whom correspondence should be addressed.
In Memoriam: Professor of Medicine, Endocrine Division, who deceased before publication of this work. Her expertise was crucial for the design and conduct of this study.
Nutrients 2019, 11(2), 347; https://doi.org/10.3390/nu11020347
Received: 3 January 2019 / Revised: 22 January 2019 / Accepted: 30 January 2019 / Published: 6 February 2019
Fiber intake is associated with better glycemic control being an important non-pharmacological treatment for diabetes (DM). We hypothesize that a dietary fiber intake can bring benefits to diabetic kidney disease (DKD), improving renal outcomes. This systematic review aimed to evaluate the effect of dietary fiber (supplemental or dietary pattern rich in fiber) on DKD. We searched six databases to identify clinical trials that reported fiber intake and renal outcomes (albuminuria, proteinuria, estimated glomerular filtration rate (eGFR) dialysis) in patients with DM. From 1814 studies, 48 papers were fully evaluated. In the end, seven trials (161 patients, aged 58.3 years, 49% females) were included. The studies were organized into three categories (vegetarian, Dietary Approaches to Stop Hypertension (DASH) diet, and fiber supplement), two evaluated supplements and five dietary patterns. Vegetarian diet reduced albuminuria in three trials, two in patients with type 1 DM and one in patients with type 2 DM; and one study demonstrated a change in the eGFR in type 1 DM. The individual quality of the studies was low/uncertain. A vegetarian dietary pattern may have a beneficial effect on these renal outcomes. However, the individual effect of the intake of fiber on DKD not was possible to be evaluated. View Full-Text
Keywords: vegetarian diet; diabetic nephropathy; albuminuria; glomerular filtration rate; systematic review vegetarian diet; diabetic nephropathy; albuminuria; glomerular filtration rate; systematic review
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Mesquita de Carvalho, C.; Azevedo Gross, L.; Jobim de Azevedo, M.; Verçoza Viana, L. Dietary Fiber Intake (Supplemental or Dietary Pattern Rich in Fiber) and Diabetic Kidney Disease: A Systematic Review of Clinical Trials. Nutrients 2019, 11, 347.

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