Effect of Low Protein Diet on Top of Dapagliflozin on Chronic Kidney Disease in Patients With Type 2 Diabetes Mellitus

This is a prospective multicenter randomized controlled trial with a total duration of 36 months aiming to evaluate the effectiveness and the safety of low protein diet on top of sodium-glucose cotransporter 2 inhibitors (SGLT2i) and renin-angiotensin-aldosterone inhibitors (RAASi) in reducing the progression of chronic kidney disease in patients with type 2 Diabetes Mellitus

Inclusion Criteria: * age\>18 years old * confirmed chronic kidney disease (with eGFR between 60 and 20 ml/min/1.73 m2 and/or proteinuria \>500 mg/g urinary creatinine) and confirmed type 2 Diabetes Mellitus * stable kidney function for at least 12 weeks before enrollment (defined as decrease in eGFR \< 5 ml/min/1.73 m2/year according to KDIGO 2012 guideline) * treatment with ACE/ARBs and/or MRAs for at least 3 months * no previous treatment with SGLT2i * good nutritional status * declared and anticipated good compliance with the prescribed diet * signed informed consent Exclusion Criteria: * eGFR \< 25 ml/min/1.73 m2 * poorly controlled arterial blood pressure (mean BP≥145/85 mm Hg) * class IV NYHA heart failure, recent MACE (less than 6 months) * relevant comorbid conditions (active infections (HBV, HCV, HIV), active neoplasia, digestive diseases with malabsorption, active autoimmune diseases/ immunosuppressive therapy) * ADPKD * kidney transplantation with functional graft * malnutrition: BMI\10% during the last 6 months, serum albumin \