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Factors affecting the progression of renal dysfunction and the importance of salt restriction in patients with type 2 diabetic kidney disease

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Abstract

Background

Type 2 diabetic kidney disease (DKD) is the most common cause of end-stage renal failure, and the prevention of its progression has been a topic of discussion.

Methods

Sixty type 2 DKD patients were retrospectively evaluated for 1 year. Factors independently affecting the annual Ccr decline were examined by multivariable linear regression analysis. Patients were further divided into 2 groups based on their degree of renal function, and between-group differences at study initiation were evaluated.

Results

Ccr values were 21.0 ± 11.8 mL/min/1.73 m2 at study initiation, and 15.7 ± 10.9 mL/min/1.73 m2 after 1 year of observation. The multivariable linear regression analysis indicated salt intake (standardized coefficient: −0.34, P = 0.010) and urinary protein excretion (standardized coefficient: −0.33, P = 0.011) to be factors independently affecting the annual Ccr decline. Although decliners (−9.8 ± 4.7 mL/min/1.73 m2/year) had a significantly higher salt intake than non-decliners (−1.1 ± 3.8 mL/min/1.73 m2/year) at study initiation, this difference disappeared at the end of the study as a result of intensive dietary education. In 21 decliners with an additional year of follow-up, the annual Ccr decline significantly improved from −10.1 ± 5.3 to −5.3 ± 7.4 mL/min/1.73 m2/year (P = 0.02).

Conclusion

Salt intake and urinary protein excretion were associated with annual Ccr decline in type 2 DKD patients. Furthermore, dietary education covering salt intake may have positively affected the change in Ccr.

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Conflict of interest

The authors have declared that no conflict of interest exists.

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Authors and Affiliations

  1. Department of Nutrition, Saitama Medical Center, Jichi Medical University, Saitama, Japan

    Noriko Kanauchi & Satsuki Mogi

  2. Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan

    Susumu Ookawara, Kiyonori Ito, Izumi Yoshida, Yoshiyuki Morishita & Kaoru Tabei

  3. Division of Endocrinology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan

    Masafumi Kakei & San-e Ishikawa

Authors
  1. Noriko Kanauchi
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  2. Susumu Ookawara
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  4. Satsuki Mogi
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  5. Izumi Yoshida
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  6. Masafumi Kakei
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Correspondence to Susumu Ookawara.

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Kanauchi, N., Ookawara, S., Ito, K. et al. Factors affecting the progression of renal dysfunction and the importance of salt restriction in patients with type 2 diabetic kidney disease. Clin Exp Nephrol 19, 1120–1126 (2015). https://doi.org/10.1007/s10157-015-1118-y

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  • DOI: https://doi.org/10.1007/s10157-015-1118-y

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