An obese patient with type 2 diabetes whose diet was changed from the recommended high-carbohydrate, low-fat type to a low-carbohydrate diet showed a significant reduction in bodyweight, improved glycemic control and a reversal of a six year long decline of renal function. The reversal of the renal function was likely caused by both improved glycemic control and elimination of the patient's obesity.
He was put on a diet of 80-90g carb a day but also restricted to 1800 calories. The diet was specificlly tailored for him. He lost weight from 100-80kg and this was acompanied by a fall HbA1c from 8+% to 6.5%, a drop in urine albumin and a more modest fall in creatinine levels . If you calculate his egfr from the numbers given he was in stage 4 CKD (egfr 22) and is still in stage 4 (egfr 29) so athough it has improved he still has poorly functioning kidneysThe reversal of the renal function was likely caused by both improved glycemic control and elimination of the patient's obesity
[/quote].In such patients, where control of bodyweight and hyperglycemia is vital, a trial with a low-carbohydrate diet may be appropriate to avoid the risk of adding obesity-associated renal failure to already failing kidneys