Hiroshi Bando
There has been various discussion about the protein restriction for diabetic nephropathy. The adequate diet was formerly low protein diet for long. After that, American Diabetes Association (ADA) revised nutrition recommendations (ADA2013), in which it denied the efficacy of a protein-restricted diet. In contrast, Japan Diabetes Association (JDA) have partly recommended low protein diet in CKD Clinical Guidelines 2013 and 2018 (CKD2018). Several related factors would be evaluated such as dietary protein intake (DPI), renal outcome, nutritional status, Geriatric Nutritional Risk Index (TNRI), the rate of eGFR decline per year and various actual protein limits per day (0.3-0.4-0.6 g / kg). Further investigation and accumulation of research data will be necessary.
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