Long-term effect of a chicken-based diet versus enalapril on albuminuria in type 2 diabetic patients with microalbuminuria

• Published in: Journal of renal nutrition Vol. 18; no. 5; p. 440
• Main Authors: de Mello, Vanessa D F, Zelmanovitz, Themis, Azevedo, Mirela J, de Paula, Tatiana P, Gross, Jorge L
• Format: Journal Article
• Language: English
• Published: United States 01.09.2008
• Subjects: Albuminuria - diet therapy; Albuminuria - drug therapy; Albuminuria - etiology; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Animals; Blood Glucose - metabolism; Chickens; Combined Modality Therapy; Diabetes Mellitus, Type 2 - complications; Diet; Dietary Proteins - pharmacology; Enalapril - therapeutic use; Female; Follow-Up Studies; Glomerular Filtration Rate - drug effects; Humans; Lipids - blood; Male; Meat; Middle Aged; Nutrition Assessment; Treatment Outcome
• ISSN: 1532-8503
• DOI: 10.1053/j.jrn.2008.04.010

In short-term studies, the replacement of red meat in the diet with chicken reduced the urinary albumin excretion rate (UAER) and improved lipid profile in type 2 diabetic patients with diabetic nephropathy. The present study sought to assess these effects over a long-term period, comparing the effects of a chicken-based diet (CD) versus enalapril on renal function and lipid profile in microalbuminuric type 2 diabetic patients. This was a randomized, open-label, controlled clinical trial with a follow-up of 1 year. The trial involved outpatients with type 2 diabetes attending a clinic of the Division of Endocrinology at a tertiary-care hospital. Twenty-eight microalbuminuric patients completed the study and were evaluated. Patients were randomized to an experimental diet (CD plus active placebo) or to treatment with enalapril (10 mg/day plus usual diet). The main outcome measure was UAER (according to immunoturbidimetry). Blood pressure, anthropometric indices, and compliance were also evaluated monthly. The glomerular filtration rate ((51)Cr-EDTA), and lipid, glycemic, and nutritional indices, were measured at baseline and quarterly. The UAER was reduced after CD (n = 13; from 62.8 [range, 38.4 to 125.1] to 49.1 [range, 6.2 to 146.5] microg/min; P < .001) and after enalapril (n = 15; from 55.8 [range, 22.6 to 194.3] to 23.1 [range, 4.0 to 104.9] microg/min; P < .001), and this was already significant at month 4. The reduction in UAER after CD (32%; 95% confidence interval, 6.7% to 57.6%) and after enalapril treatment (44.7%; 95% confidence interval, 28.3% to 61.1%; P = .366) were not significantly different. The CD and the angiotensin-converting enzyme inhibitor enalapril promoted a similar reduction of UAER in patients with type 2 diabetes and microalbuminuria in a 12-month follow-up period.