Chicken-Diet vs. Enalapril to Reduce Albuminuria
Chicken-Diet vs. Enalapril to Reduce Albuminuria
Diabetic nephropathy (DN) is a chronic diabetic complication and affects up to 40% of
 patients. The first line treatment for DN is angiotensin blockers drugs that are used to
 reduce the protein concentration in urine.Previous data showed that this protein, namely
 albuminuria, could also be reduced in a short term-period by the replacement of red meat in
 the diet with chicken. The aim of this study is to compare the effects of this chicken diet
 with enalapril on albuminuria in a long-term period( 12 months)in type 2 diabetic patients.
Replacement of red meat in the diet with chicken reduces urinary albumin excretion rate
 (UAER) and improves lipid profile in type 2 diabetic patients with micro- and
 macroalbuminuria in short term studies. The aim of this study was to compare the long-term
 effect of a chicken-based diet (CD) versus enalapril treatment on renal function and lipid
 profile in microalbuminuric type 2 diabetic patients. In this 12-month controlled clinical
 trial 28 patients were randomized to an experimental diet (CD plus active placebo) or
 enalapril treatment (enalapril 10 mg/day plus patient's usual diet). UAER
 (immunoturbidimetry), blood pressure levels, anthropometric indices, and compliance with the
 diet were evaluated monthly. Glomerular filtration rate (51Cr-EDTA), lipid, glycemic, and
 nutritional indices were measured at baseline, and quarterly. UAER was reduced after CD
 [n=13; 62.8 (38.4-125.1) to 49.1 (6.2-146.5) mcg/min; P<0.001] and after enalapril treatment
 [n=15; 55.8 (22.6-194.3) to 23.1 (4.0-104.9) mcg/min; P<0.001]. The reduction of UAER was
 already significant at 4th month, and there was no difference between the UAER reduction
 after CD [32% (95% CI: 6.7-57.6) and after enalapril treatment [44.7% (95% CI: 28.3-61.1);
 P=0.366]. In conclusion, CD and the ACE inhibitor enalapril promoted similar UAER reduction
 in patients with type 2 diabetes and microalbuminuria. A chicken-based diet might represent
 an additional therapeutic approach to management of diabetic nephropathy.
Inclusion Criteria:

 -  Patients with type 2 diabetes mellitus (according to World Health Organization
 criteria) attending the Endocrine Division's outpatient clinic at Hospital de Clínicas
 de Porto Alegre, Brazil. Patients were selected according to the following criteria:
 age <75 years, A1c <10%, 24-hour UAER 20 mcg/min and 199 mcg/min confirmed at least
 twice in a 6-month period, serum triglycerides <400 mg/dl and normal liver and thyroid
 function tests.

 Exclusion Criteria:

 -  Patients were excluded from the study if they had BMI >34 kg/m2, serum creatinine >1.5
 mg/dl, repeated episodes of urinary tract infection, other renal diseases, symptomatic
 autonomic neuropathy, heart failure, and acute myocardial infarction, coronary artery
 revascularization procedures or stroke within the last 6 months.