Special Issue "Diabetic Nephropathy and Nutrition Promotion Intervention"
Deadline for manuscript submissions: 31 January 2021.
Department of Nephrology Transplantology and Internal Medicine, Clinical Hospital in Gdańsk
Interests: nephrology; clinical nutrition; malnutrition; insulin resistance; adipokines
Diabetes type 1 and 2 both affect vision, cause muscle atrophy, neuropathy, nephropathy, and increase cardiovascular risk. Nowadays, the risk of diabetic kidney disease among type 1 diabetic patients is 20-30%. In type 2 diabetic patients, prevalence increases with age and is about 20%. Diabetes, particularly type 2, is associated with several metabolic abnormalities, not only hyperglycemia but also genetic factors predisposed to renal lesions. Hyperfiltration is characteristic for diabetic nephropathy, but at a late stage proteinuria develops with a progressive decline in kidney function. Recently, diabetic nephropathy is most common cause of end-stage renal disease, as more than 50% of patients who qualify for renal replacement therapy have diabetes.
The main and most important aspects of the treatment, including dietary management, of the patients with advanced diabetic nephropathy and deterioration of kidney function are glycemic control, blood pressure control, slowing progression and prevention of malnutrition.
Data from NHANES showed that for patients with GFR 55 -80 ml/min/1.73 m2 at baseline, protein intake was significantly correlated with a reduction in eGFR of almost 2 ml/min/1.73 m2 for every 10 g increase in protein consumption. The effect of protein on GFR was greatest in adults with the highest intake of nondairy animal protein. A high-protein diet is usually associated with high salt intake. Also, other diet components like carbohydrates and fats may influence the progression of diabetic nephropathy. Results of several retrospective analyses and prospective clinical trials suggest that alkali therapy benefits patients with progressive diabetic kidney disease. But question: do dietary factors contribute to the development or progression of diabetic nephropathy?
There is a considerable increase in the number of people with diabetes type 2 in the world. The most common is diabetes type 2, accompanied with obesity. However, in the case of patients with complications of diabetes in the form of micro and/or macroangiopathy, the growing signs of malnutrition are observed, often despite a high body mass index. Early diagnosis of nutritional disorders and appropriate diet modification is an important element of treatment of people with diabetes.
Malnutrition is one of the most important clinical problems complicating the course of chronic diseases (from 25% up to 75% of patients) and the results of studies are an important element on the path of understanding pathomechanisms, the actual impact on morbidity and mortality, as well as treatment options in these groups of patients. Comprehensive treatment, including nutritional status, can reduce the number of patients with diabetes who require renal replacement therapy and improve their prognosis.
Prof. Dr. Sylwia Malgorzewicz
Manuscript Submission Information
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- Diabetic kidney disease
- Diabetes type 1 and 2
- Nutrition and Nutritional intervention
- Obesity and malnutrition in diabetic kidney disease
- Diabetes and end-stage renal disease