ABSTRACT
Diabetic kidney disease is the greatest cause of kidney disease worldwide and a cause of significant morbidity and mortality - in New Zealand it accounts for more than 50 of patients receiving renal dialysis. Diet and lifestyle modification are recognised as the cornerstones of management of type 2 diabetes. Dietary interventions to aid weight loss and improve glycaemic control typically increase total energy intake from protein by about 10. The effects of increased protein intake on kidney function and progression of kidney disease in type 2 diabetes has not been established. Evaluation of the literature reviewed here suggests that there is some evidence for the benefit of treating existing nephropathy with protein restriction; but no evidence that increasing protein intake in patients with microalbuminuria accelerates diabetic nephropathy; or causes it in those with normal renal function. Substituting chicken; fish and vegetable protein sources for red meat may be helpful; while retaining a focus on other aspects of a healthy diet; such as high fibre; will ensure that potential risks are minimised