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

• Published in: Nutrients Vol. 11; no. 2; p. 347
• Main Authors: Carvalho, Cláudia Mesquita de, Gross, Luiza Azevedo, de Azevedo, Mirela Jobim, Viana, Luciana Verçoza
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 06.02.2019; MDPI
• Subjects: albuminuria; Carbohydrates; Cardiovascular disease; Chronic illnesses; Clinical trials; Clinical Trials as Topic; Diabetes; Diabetes mellitus; Diabetic Nephropathies - diet therapy; Diabetic Nephropathies - etiology; Diabetic nephropathy; Diet; Diet - methods; Dietary fiber; Dietary Fiber - therapeutic use; Dietary intake; Dietary Supplements; Female; glomerular filtration rate; Handbooks; Humans; Hypertension; Intervention; Kidney - metabolism; Kidney diseases; Kidneys; Male; Middle Aged; Mortality; Nutrition research; Proteins; Renal function; Review; Systematic review; Treatment Outcome; vegetarian diet; vegetarian diet; albuminuria; systematic review; glomerular filtration rate; diabetic nephropathy
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu11020347

Fiber intake is associated with better glycemic control being an important nonpharmacologicaltreatment for diabetes (DM). We hypothesize that a dietary fiber intake can bringbenefits to diabetic kidney disease (DKD), improving renal outcomes. This systematic review aimedto evaluate the effect of dietary fiber (supplemental or dietary pattern rich in fiber) on DKD. Wesearched 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 58.3years, 49% females) were included. The studies were organized into three categories (vegetarian,Dietary Approaches to Stop Hypertension (DASH) diet, and fiber supplement), two evaluatedsupplements and five dietary patterns. Vegetarian diet reduced albuminuria in three trials, two inpatients with type 1 DM and one in patients with type 2 DM; and one study demonstrated a change inthe eGFR in type 1 DM. The individual quality of the studies was low/uncertain. A vegetarian dietarypattern may have a beneficial effect on these renal outcomes. However, the individual effect of theintake of fiber on DKD not was possible to be evaluated.