Very Low Calorie Diet for Diabetic Kidney Disease

The purpose of this study is to determine whether a very low calorie diet will stabilize or improve diabetic kidney disease.

Inclusion Criteria:

• Type 2 Diabetes
• Age > 18
• Body mass index ≥ 30
• Presumed or biopsy-proven diabetic nephropathy
• Estimated GFR < 40 ml/min/1.73 meters squared
• Proteinuria > 0.5 gm/day
• Motivated to lose weight
• Stable medical co-morbidities
• Using an ACE inhibitor or angiotensin receptor blocker agent (unless contraindicated)

Exclusion Criteria:

• Inability to sign informed consent
• Life expectancy of < 1 year
• Expected need for initiation of dialysis within 9 months
• Type 1 Diabetes
• Recent myocardial infarction or stroke (past 3 months)
• Unstable angina
• Active cancer
• Pregnancy/lactation
• Serious psychiatric diseases
• Substance abuse
• Uncontrolled hypertension (> 180/110)
• Ineligible for VLCD based on laboratory data