Renal Function Following Three Distinct Weight Loss Dietary Strategies During

OBJECTIVEdThis study addressed the long-term effect of various diets, particularly low-carbohydrate high-protein, on renal function on participants with or without type 2 diabetes. RESEARCH DESIGN AND METHODSdIn the 2-year Dietary Intervention Random-ized Controlled Trial (DIRECT), 318 participants (age, 51 years; 86%men; BMI, 31 kg/m2; mean estimated glomerular filtration rate [eGFR], 70.5mL/min/1.73m2;mean urinemicroalbumin-to-creatinine ratio, 12:12) with serum creatinine,176 mmol/L (eGFR$30 mL/min/1.73 m2) were randomized to low-fat, Mediterranean, or low-carbohydrate diets. The 2-year compliance was 85%, and the proportion of protein intake significantly increased to 22 % of energy only in the low-carbohydrate diet (P, 0.05 vs. low-fat and Mediterranean). We examined changes in urinarymicroalbumin and eGFR, estimated byModification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration formulas. RESULTSdSignificant (P, 0.05within groups) improvements in eGFRwere achieved in low-carbohydrate (+5.3 % [95 % CI 2.1–8.5]), Mediterranean (+5.2 % [3.0–7.4]), and low-fat diets (+4.0 % [0.9–7.1]) with similar magnitude (P. 0.05) across diet groups. The increased eGFR was at least as prominent in participants with (+6.7%) or without (+4.5%) type 2 diabetes o