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ISSN 0973 - 0958
Diet and
Disease
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DIET IN NEPHROTIC SYNDROME
Nutritional management:
One of the aims of nutritional management is to replace as much of the protein loss in the urine by a intake of good quality protein. The dietary modification may be as follows:
One of the aims of nutritional management is to replace as much of the protein loss in the urine by a intake of good quality protein. The dietary modification may be as follows:
- Protein: A balanced diet adequate in both energy and protein (1-2gms per kilogram body weight) should be adequate for most children. Since Indian children usually have a low intake of protein (even less than the RDA), adequate protein intake - upto 2gm/kg/day in children and not more than 3gm/kg/day in infants is advocated. A very high protein diet may cause tubular damage to the kidneys as the kidneys will have to filter more of the proteins.
Foodstuffs rich in protein are cow's milk, skimmed milk, eggs, fish, dry fish, chicken, lean meat, paneer made from cow's milk, cheese, sprouts, pulses and legumes such as tur dal, moong dal, rajmah, chana, lentils (masoor), etc. - Calories: A high calorie diet so as to conserve protein should be necessary. However fat content is not increased in the diet as patients with nephrotic syndrome have high serum trigylcerides.
- Sodium: To prevent massive oedema, sodium levels in the diet must be low. Usually 500mg sodium diet is satisfactory. Salt should be restricted but diets should be palatable. Usually added salt is prohibited in these children. Table below indicates some of the foodstuffs high in sodium:
FOODSTUFFS HIGH IN SODIUM |
| Baking soda |
| Salt |
| Ajinomoto |
| Salted wafers, popcorns, salted biscuits. |
| Papads - all varieties. |
| Salted pickles, chutneys, curry powder - commercial. |
| Commercial salad dressings and sauces. |
| Soup cubes. |
| Soft drinks containing sodium benzoate. |
| Bakery products, bread, biscuits. |
| Nuts such as salted cashewnuts, pistachio, walnuts, peanuts. |
| Commercial cheese. |
| Preservative containing foods. |
| Canned and tinned foods. |
| Sea food, chicken, dry fish, bacon, ham . |
| Meat and yeast extracts like marmite. |
| Proprietary drinks - Bournvita, chocolate drinks, Horlicks. |
| Milk and curds. |
| Pulses and legumes - all varieties. |
| Vegetables such as - cauliflower , snakegourd , beetroot , carrot , coriander leaves, fenugreek(methi) leaves, lettuce ,spinach (palak) ,amaranth, radish |
• Fats/oils: It is recommended that as part of the initial general healthy eating advice, oils and saturated fats(ghee, butter, margarine, coconut oil) should be avoided. |
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