Paper
International Journal of Obesity (2005) 29, 1115–1120. doi:10.1038/sj.ijo.0803009; published online 31 May 2005
Effect of weight loss using formula diet on renal function in obese patients with diabetic nephropathy
A Saiki1, D Nagayama2, M Ohhira1, K Endoh1, M Ohtsuka1, N Koide1, T Oyama1, Y Miyashita1 and K Shirai2
- 1Center of Diabetes, Endocrine and Metabolism, Sakura Hospital, School of Medicine, Toho University, Chiba, Japan
- 2Internal Medicine, Sakura Hospital, School of Medicine, Toho University, Chiba, Japan
Correspondence: Dr Y Miyashita, Center of Diabetes, Endocrine and Metabolism, Sakura Hospital, School of Medicine, Toho University, 564-1, Shimoshizu, Sakura-City, Chiba 285-8741, Japan. E-mail: mumon@sf6.so-net.ne.jp
Received 18 September 2004; Revised 28 March 2005; Accepted 4 April 2005; Published online 31 May 2005.
Abstract
OBJECTIVE:
To evaluate the effect and safety of treatment with low-calorie formula diet on renal function and proteinuria in obese patients with diabetic nephropathy.
DESIGN:
Prospective study on safety and efficacy of a 4-week low-calorie (11–19 kcal/kg/day) normal-protein (0.9–1.2 g/kg/day) diet partly supplemented with formula diet.
SUBJECTS:
In all, 22 obese patients with diabetic nephropathy (BMI: 30.4
5.3 kg/m2, HbA1c: 7.11.4%, serum creatinine: 172.457.5 
mol/l, urinary protein: 3.32.6 g/day).
RESULTS:
The mean body weight decreased by 6.23.0 kg. The mean systolic blood pressure, creatinine, blood urea nitrogen, urinary protein, and 8-hydroxydeoxyguanosine decreased significantly by 7.512.7 mmHg, 41.623.9 mol/l, 1.501.61 mmol/l, 1.81.7 g/day, and 3.13.6 ng/mg creatinine, respectively. No patient had increased serum creatinine and urinary protein. Mean creatinine clearance (40.617.9 to 46.114.6 ml/s/1.73 m2) and serum albumin showed no significant changes. 
serum creatinine and urinary protein correlated with body weight (r=0.62 and 0.49, respectively) and visceral fat area (r=0.58 and 0.58, respectively), but did not correlate with systolic blood pressure, fasting blood glucose and subcutaneous fat area.
CONCLUSION:
These results suggested that weight reduction using formula diet might improve renal function and proteinuria safely for a short term in obese patients with diabetic nephropathy.
Keywords:
diabetic nephropathy, formula diet, oxidative stress, visceral fat
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