Ruggenenti, PieroCortinovis, MonicaTrillini, MatiasParvanova, AneliyaAbbate, ManuelaSatriano, ChiaraSalvetti, FerdinandoBossi, Antonio CTrevisan, RobertoPerna, AnnalisaPeracchi, TobiaRubis, NadiaDiadei, OlimpiaMartinetti, DavideGaspari, FlavioFontana, LuigiRemuzzi, GiuseppeCRESO 2 Study Organization2024-10-042024-10-042022-03Ruggenenti P, Cortinovis M, Trillini M, Parvanova A, Abbate M, Satriano C, et al. Long-term kidney and systemic effects of calorie restriction in overweight or obese type 2 diabetic patients (C.Re.S.O. 2 randomized controlled trial). Diabetes Res Clin Pract. 2022 Mar;185:109804. Epub 2022 Feb 24.1872-8227https://hdl.handle.net/20.500.13003/19669https://hdl.handle.net/20.500.12105/23474Aims: In type 2 diabetic patients with obesity, hyperfiltration is a risk factor for accelerated glomerular filtration rate (GFR) decline and is ameliorated by calorie restriction (CR). We assessed whether CR-induced amelioration of hyperfiltration could translate into slower long-term GFR decline in this population. Methods: In this academic, single-center, parallel-group, prospective, randomized, open-label, blinded endpoint trial, consenting >40-year-old patients with type 2 diabetes, BMI ≥27 kg/m2, creatinine <1.2 mg/dL and albuminuria ≤300 mg/24 h were randomized (1:1) to two-year 25% CR (n = 53) or standard diet (SD, n = 50). Primary outcome was 6-month measured GFR. Analyses were by modified intention-to-treat. Results: At 6 months GFR decreased by 5.16 ± 10.03 mL/min (P = 0.001) with CR, and by 0.98 ± 9.71 mL/min (P = 0.497) with SD. Between-group difference was significant (P = 0.044). GFR decline from 6 to 24 months was significant with SD (P < 0.01), but not with CR (P = 0.075). Between-group difference, however, was not significant (P = 0.414). Body weight, BMI, waist circumference, systolic blood pressure, HbA1c, blood glucose, serum triglycerides decreased and ApoA-I concentration increased with CR. No changes were observed with SD. Between-group differences were significant. CR was tolerated well. Conclusions: In obese type 2 diabetic patients, CR ameliorated glomerular hyperfiltration and several cardiovascular risk factors, and blunted long-term GFR decline. Trial registration: NCT01930136.enghttp://creativecommons.org/licenses/by-nc-nd/4.0/Calorie restrictionCardiovascular riskNephropathyObesityType 2 diabetesDiabetes Mellitus, Type 2AdultHumansKidneyObesityMaleProspective StudiesFemaleCaloric RestrictionAlbuminuriaOverweightDiabetic NephropathiesGlomerular Filtration Rateresearch articleAttribution-NonCommercial-NoDerivatives 4.0 International3521976218510980410.1016/j.diabres.2022.109804Diabetes Research and Clinical Practiceopen accessFemeninoMasculinoRestricción CalóricaRiñónHumanosObesidadEstudios ProspectivosDiabetes Mellitus Tipo 2AdultoTasa de Filtración GlomerularNefropatías DiabéticasSobrepesoAlbuminuria2-s2.0-85125557637810140100004L2017098851