Protein-reduced diet in diabetic renal failure.

The effect of treatment with a protein-reduced diet (20-30 g/day) and essential amino acids was studied in 21 patients with diabetes mellitus and renal failure. The mean treatment time was 5.0 (0.5-14) months. Most patients experienced considerable amelioration of their uremic symptoms and the mean serum value was reduced by 50% of the initial value during treatment. Residual renal function continued to decrease during treatment. Vigorous treatment of fluid retention and hypertension was a prerequisite for a successful course and may also have decreased the rate of progression towards dialysis. Compliance with the diet was not different from that found in non-diabetic uremic patients. Satisfactory control of blood glucose levels was obtained with no or only minor adjustments of the insulin dosage. It is concluded that dietary therapy should be considered in diabetic patients with renal failure for treatment of uremic symptoms.