NEPHROTIC SYNDROME - CLINICAL SYMPTOMS AND DIETARY MODIFICIATION
Nephrotic syndrome can be caused due to progressive glomerulonephritis,
diabetes meltitus, drugs and toxic venom.
Symptoms
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.
DIETARY TREATMENT
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.
Sodium
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.
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