To the content
1 . 2021

Optimization of dietary support for patients with diabetic nephropathy


The article presents modern approaches to dietary support for patients with diabetic nephropathy (DN). The possibility of using the developed specialized products (SP), modified by protein, fat and carbohydrate composition, containing food ingredients with hypoglycemic, hypolipidemic and antioxidant effects is presented.

The aim - development of a formulation and technology for producing SP with modified chemical composition and energy value, intended for inclusion in a low-protein diet for patients with DN.

Material and methods. When developing the SP formulation, soy protein isolate, mono-and polyunsaturated fatty acids, soluble dietary fiber, fat- and water-soluble vitamins, tracelements, curcumin, taurine, flavoring and aromatic additives were used.

Results. The chemical composition and organoleptic characteristics of two SPs have been determined. A technology has been developed for producing SP in the form of instant drinks, which consists in stage-by-stage mixing of prescription ingredients, which ensures uniform distribution of minor biologically active substances. The conducted studies of the organoleptic parameters of the developed SPs showed an average overall score of 4.8 and 4.9 on a 5-point scale.

Conclusion. Taking into account the technological and organoleptic compatibility of the selected ingredients, formulations and technologies for preparing SP have been developed, which are powdery multicomponent mixtures for preparing drinks for use in the complex therapy of patients with DN.

Keywords:diabetes mellitus, diabetic nephropathy, medical nutrition therapy, nutritional value, specialized product

Funding. Research was carried out at the expense of the state budget for the implementation of the state task for research.

Conflict of interests. The authors declare no obvious and potential conflicts of interest related to the publication of this article.

For citation: Sharafetdinov Kh.Kh., Shekhetov A.A., Plotnikova O.A., Vorobyeva V.M., Vorobyeva I.S., Kochetkova A.A., Pilipenko V.V., Alexeeva R.I. Optimization of dietary support for patients with diabetic nephropathy. Voprosy pitaniia [Problems of Nutrition]. 2021; 90 (1): 85-93. DOI: (in Russian)


1. Algorithms of specialized medical care for patients with diabetes. In: I.I. Dedov, M.V. Shestakova, A.Yu. Mayorov (eds). 9th ed. Moscow: UP PRINT, 2019. DOI: (in Russian)

2. Ermolenko V.M., Kozlova T.A., Mikhaylova N.A. the Importance of low-protein diet in slowing the progression of chronic renal failure (literature review). Nefrologiya i dializ [Nephrology and Dialysis]. 2006; 8 (4): 310–9. (in Russian)

3. Handbook of Nutrition and Kidney. 5th ed. In: W.E. Mitch, S. Klahr (eds). Philadelphia: Lippincott Williams and Wilkins, 2005: 330 p.

4. Piccoli G.B., Capizzi I., Vigotti F.N., Leone F., D’Alessandro C., Giuffrida D., et al. Low protein diets in patients with chronic kidney disease: a bridge between mainstream and complementary-alternative medicines? BMC Nephrol. 2016; 17 (1): 76. DOI:

5. KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Diabetes and Chronic Kidney Disease. Am J Kidney Dis. 2007; 49 (2 suppl 2): S12–154. DOI:

6. American Diabetes Association. 11. Microvascular complications and foot care: standards of medical care in diabetes-2020. Diabetes Care. 2020; 43 (suppl 1): S135–51. DOI:

7. American Diabetes Association. Diabetic nephropathy. Diabetes Care. 2003; 26 (S1): S94–8. DOI:

8. Patent No. 2519744 C2 Russian Federation, IPC A61K 36/734; A61K 36/533; A61P 3/10; A61P 3/06. Pharmaceutical composition, agent for the prevention and treatment of metabolic syndrome and diabetic nephropathy and method for its production. Authors: Bezpalko L.V., Rzhepetskaya I.N., Sova E.A., Gorbenko N.I., Ivanova O.V., Zvyagina T.S., Kobylinskaya V.I., Tishchenko R.A., Dobrovol’ny A.A., Shalamay A.S., patent holder: Bezpalko L.V., Shalamay A.S. No. 2011125805/15; declared 06.24.2011; publ. 06.20.2014, Bull. No. 17 (in Russian).

9. Nakaya Y., Minami A., Harada N., et al. Taurine improves insulin sensitivity in the Otsuka Long-Evans Tokushima fatty rat, a model of spontaneous type 2 diabetes. Am J Clin Nutr. 2000; 71 (1): 54–8. DOI:

10. Ito T., Schaffer S.W., Azuma J. The potential usefulness of taurine on diabetes mellitus and its complications. Amino Acids. 2012; 42 (5): 1529–39. DOI:

11. Yalcinkaya S., Unlucerci Y., Giris M., et al. Oxidative and nitrosative stress and apoptosis in the liver of rats fed on high methionine diet: protective effect of taurine. Nutrition. 2009; 25 (4): 436–44. DOI:

12. Taurine – monograph. Altern Med Rev. 2001; 6 (1): 78–82.

13. Plant sources of phytonutrients for specialized foods with antidiabetic effects. In: V.A. Tutel’yan, T.L. Kiseleva, A.A. Kochetkova (eds). Moscow: BIBLIO-GLOBUS, 2016: 420 p. ISBN 978-5-9909097-5-5. (in Russian)

14. Eddouks M., Bidi A., El Bouhali B., et al. Antidiabetic plants improving insulin sensitivity. J Pharm Pharmacol. 2014; 66 (9): 1197–214. DOI:

15. Den Hartogh D.J., Tsiani E. Antidiabetic properties of curcumin ii: evidence from in vivo studies. Nutrients. 2019; 12 (1). DOI:

16. Wickenberg J., Ingemansson S.L., Hlebowicz J. Effects of Curcuma longa (turmeric) on postprandial plasma glucose and insulin in healthy subjects. Nutr J. 2010; 9: 43. DOI:

17. Miranda-Díaz A.G., Pazarín-Villaseñor L., Yanowsky-Escatell F.G., Andrade-Sierra J. Oxidative stress in diabetic nephropathy with early chronic kidney disease. J Diabetes Res. 2016; 2016: 7047238. DOI:

18. Kucher A.G., Kayukov I.G., Grigor’eva N.D., Vasil’ev A.N. Nutrition in different stages of chronic kidney disease. Nefrologiya i dializ [Nephrology and Dialysis]. 2007; 9 (2): 118–35. (in Russian)

19. Smirnov A.V., Beresneva, O.N., Parastaeva M.M., et al. Influence of a low-protein diet (LPD) supplemented by Ketosteril and soy-been isolate on the development of experimental renal failure. Nefrologiya i dializ [Nephrology and Dialysis]. 2006; 8 (4): 344–50. (in Russian)

20. Tutelyan V.A. The chemical composition and calorie content of Russian food. Handbook. Moscow: DeLi Plus, 2012: 284 p. (in Russian)

21. Sharafetdinov Kh.Kh., Shekhetov A.A., Plotnikova O.A. Modern approaches to dietary support for patients with diabetic nephropathy. Voprosy pitaniia [Problems of Nutrition] 2018; 87 (6): 6–15. DOI: (in Russian)

22. Fair D.E., Ogborn M.R., Weiler H.A., et al. Dietary soy protein attenuates renal disease progression after 1 and 3 weeks in Han: SPRD-cy Weanling rats. J Nutr. 2004; 134: 1504–7. DOI:

23. Jing Z., Wei-Jie Y. Effects of soy protein containing isoflavones in patients with chronic kidney disease: a systematic review and meta-analysis. Clin Nutr. 2016; 35 (1): 117–24. DOI:

24. Hansen H.P., Tauber-Lassen E., Jensen B.R., Parving H.H. Effect of dietary protein restriction on prognosis in patients with diabetic nephropathy. Kidney Int. 2002; 62 (1): 220–8. DOI:

25. Nezu U., Kamiyama H. Kondo Y., et al. Effect of low-protein diet on kidney function in diabetic nephropathy: meta-analysis of randomized controlled trials. BMJ Open. 2013; 3 (5): 1–11. DOI:

26. Pan Y., Guo L.L., Jin H.M. Low-protein diet for diabetic nephropathy: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2008; 88 (3): 660–6. DOI:

27. Zhang J., Liu J., Su J., Tian F. The effects of soy protein on chronic kidney disease: a meta-analysis of randomized controlled trials. Eur J Clin Nutr. 2014; 68 (9): 987–93. DOI:

28. Sharafetdinov Kh.Kh., Plotnikova O.A., Nazarova A.M., et al. Specialized foods with a modified carbohydrate profile in the correction of metabolic disorders in type 2 diabetes. Voprosy pitaniia [Problems of Nutrition] 2017; 86 (6): 56–63. DOI: (in Russian)

29. Tutelyan V.A., Sharafetdinov Kh.Kh., Lapik I.A., Vorobyeva I.S., Sukhanov B.P. Priorities in the development of specialized foods of optimized composition for patients with type 2 diabetes. Voprosy pitaniia [Problems of Nutrition] 2014; 83 (6): 41–51. DOI: (in Russian)

30. Ko G.J., Kalantar-Zadeh K., Goldstein-Fuchs J., Rhee C.M. Dietary approaches in the management of diabetic patients with kidney disease. Nutrients. 2017; 9: 824. DOI:

31. Shapiro, H., Theilla M., Attal-Singer J., Singer P. Effects of polyunsaturated fatty acid consumption in diabetic nephropathy. Nat Rev Nephrol. 2011; 7: 110–21. DOI:

SCImago Journal & Country Rank
Viktor A. Tutelyan
Full Member of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor, Scientific Director of the Federal Research Centre of Nutrition, Biotechnology and Food Safety (Moscow, Russia)
Medicine today

II Конференция онкологов Московской области Москва, 4 июня 2021 года Подмосковье в настоящее время - это регион, переживающий бурный прирост населения и активную урбанизацию. Эти процессы требуют изменений в организации оказания медицинской помощи, в первую очередь,...

Приглашаем вас принять активное участие в работе XII Международной конференции "Актуальные аспекты экстракорпорального очищения крови в интенсивной терапии". Мероприятие пройдет 28-29 мая 2021 года в онлайн-формате. Конференция организована при поддержке Министерства...

Конференция РАРЧ "Репродуктивное здоровье и эпидемия COVID-19: год спустя" 8 июня 2021 г., онлайн Коронавирусная инфекция внесла существенные коррективы в работу специалистов в области репродуктивного здоровья. За прошедший год мы преодолели множество совершенно необычных...

Journals of «GEOTAR-Media»