Editorial - (2020) Volume 4, Issue 2
Received: 21-Jan-2020
Published:
12-Jun-2020
Citation: Hiroshi Bando. Ã????Ã???Ã??Ã?¢??Inconsistent efficacy of low protein diet for diabetic nephropathyÃ????Ã???Ã??Ã?¢?Ã????Ã???Ã??Ã?Â. Clin Med Case Rep 4 (2020):e128.
Copyright: �????�???�??�?�© 2020 Bando H. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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.
Angiotensin-Converting Enzyme inhibitors (ACEIs) and Angiotensin Receptor Blockers (ARBs) initially used to treat hypertension. They can use to treat diabetes, Chronic Renal Insufficiency (CRI)(RI), Congestive Heart Failure (CHF)(HF), and myocardial infarction (MI). They recorded to have some Adverse Effects (AEs) such as Acute Renal Failure (ARF) due to the lack of appropriate timelines monitoring scheme. The following Systematic Review (SR) will focus on the AEs of the administration of ACEIs/ARBs without appropriate timelines monitoring on adult patients as the specific population under study as per the prevailing literature provides. The data sources include a search for English language literature in the Cochrane database (2015-2019), MEDLINE, and the American Heart Association Journal Database (AHA). The search terms in the above databases included ACEIs /ARBs, adults, clinical trials, laboratory trials, random trails, humans, and timeline monitoring. The study selection included literature with random control trials of patients with the above diseases and how the appropriate monitoring of ACEIs/ARBs had any effects on the angiotensin system in adults. The data extraction is based on eight sources while keeping in mind the data fields used and the quality of the studies conducted. The data synthesis criteria observed a pool of patients larger than 50,000 included in each study that was put under the administration of ACEIs/ARBs for a year while noting the appropriate timelines monitoring of ACEIs/ARBs on the potassium and creatinine and how they affect the patients if they are not properly monitored. The SR of these laboratory studies confirms that under appropriate timelines monitoring of the administration of ACEIs/ARBs, apart from treating the above diseases, have very limited AEs on the renin-angiotensin-aldosterone system of the patients under observation.
Diabetic nephropathy • low protein diet • Diabetes Practice Guidelines 2019 (JDS2019) • 2019 dietary consensus report (ADA2019) • Geriatric Nutritional Risk Index (GNRI)
Clinical and Medical Case Reports received 40 citations as per Google Scholar report
