NEPHROTIC SYNDROME - CLINICAL SYMPTOMS AND DIETARY MODIFICIATION
Nephrotic syndrome can be caused due to progressive glomerulonephritis, diabetes meltitus, drugs and toxic venom.
In Nephrosis, proteinuria along with oedema is present. Large urinary losses of albumin and other plasma proteins lead to tissue wastage, fatty liver, malnutrition and increased susceptibility to infection.
Principles of Diet
Restricted protein, high carbohydrate, salt restricted moderate fat with restricted fluid are recommended for a nephrotic patient. Vitamin supplements especially vitamin C should be given. Low quality proteins like pulses should be mixed with cereals and milk to improve quality of protein. High quality proteins like egg and meat are preferred.
Energy and protein
To ensure protein use for tissue synthesis, sufficient kilo calories must be provided 2000 kcals is suggested. Since appetite is poor, food must be appetizing and diet soft. Moderate protein restriction 0.5-0.6 g/kg is needed. When urinary protein losses are greater than 10 g / day, protein malnutrition occurs.
Diuretics and sodium restriction are used to prevent further accumulation of fluid and prevent hypertension. The level of sodium permitted is usually less than 2g per day or even 500 mg / day. No salt is added while cooking or on the table.
Low sodium foods can be consumed. Sodium intake is liberalized when oedema is corrected. Potassium supplements are essential as calcium and potassium deficiency may accompany severe proteinuria.