CHICKEN AND FISH DIET REDUCES GLOMERULAR HYPERFILTRATION IN IDDM PATIENTS

OBJECTIVE - To compare the effect of a normal protein diet (test diet) in which chicken and fish were substituted for red meal with a low-pr otein diet (LPD) on glomerular filtration rate (GFR) in normoalbuminur ic insulin-dependent-diabetes mellitus (IDDM) patients. RESEARCH DESIG N AND METHODS - A crossover randomized clinical trial was performed in 15 normoalbuminuric IDDM patients, 9 normofiltering, and 6 hyperfilte ring patients. They followed three diets for a 3-week period each: a u sual diet (UD), an LPD (0.5 g . kg(-1) . day(-1) of proteins, 7% calor ies as protein, 33% as fat, and 60% as carbohydrates), and a normoprot eic isocaloric test diet in which white meat (chicken and fish) was su bstituted for red meat of the UD. At the end of each diet, a clinical evaluation and measurements of GFR (Cr-51-ethylenediaminetetraacetate (EDTA) single injection technique), urinary albumin excretion (UAE), a nd plasma amino acids were performed. Dietary compliance was assessed by a 24-h urinary urea and weekly interviews with the dietitian. RESUL TS - In all diabetic patients, GFR after the LPD (114.9 +/- 16.5 ml . min(-1) . 1.73 m(-2)) and after the test diet (122.7 +/- 16.7 ml . min (-1) . 1.73 m(-2)) was significantly lower than after the UD (132.0 +/ - 27.7 ml . min(-1) . 1.73 m(-2)) (P = 0.001). Similar results were fo und in the hyperfiltering group: after UD = 161.1 +/- 15.4 ml . min(-1 ) . 1.73 m(-2), after LPD = 129.8 +/- 9.0 ml . min(-1) . 1.73 m(-2) an d after the test diet = 136.5 +/- 3.1 ml . min(-1) . 1.73 m(-2), (P < 0.001). In the normofiltering group, no significant changes in GFR wer e observed after the three diets. Metabolic control, nutritional index es, blood pressure (BP), and UAE did not change after the three diets in all patients. CONCLUSIONS - A normoproteic diet with chicken and fi sh as the only meat protein source decreases the GFR in the hyperfilte ring normoalbuminuric IDDM patients. The GFR reduction after this diet is similar to that observed after an LPD.