Nutrition For Children With Nephrotic Syndrome

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Sunanda and Shankar is a successful working Parent. Their son, Rahul, is turning 5 next week. But their concentration was more over the behavioural changes of their son. Rahul was quite irritated from past couple of weeks. Sunanda observed swelling over body, face turning pale and there was an appetite loss too. Lastly they thought to meet a Doctor. On examining, Doctor advised for urine and blood test. Report shown protein excretion was more than 40 mg/m2/h, other reports suggested hyperlipidemia (when blood cholesterol & Fat levels are raised) and albuminuria (when urine has high levels of albumin protein). Other necessary investigation were also done, checked & confirmed by the Doctor. Later, Rahul was diagnosed to have Nephrotic syndrome.
After advising medicines and follow up, Doctor suggested to meet a clinical Nutritionist to further understand the role of nutrition which is as important as the medicine for him.

Clinical & Nutrition Assessments were done and parents were counselled for the necessary dietary modification. Sunanda and Shankar were so surprised that Rahul need to stop from the protein overload, unlikely to what they have been feeding him, unknowingly of course!

What should be the diet for your children in Nephrotic syndrome?
Excess of protein (sources includes meat/ fish/ Eggs, Pulses & legumes, Milk & milk products, Soya) should be avoided : because a diet rich in protein may cause tubular damage to the kidneys and kidney load to filter proteins will be raised. Protein intake should be as per your diet prescription.

Check on High amount of fats in diet: Excess of oily food and saturated fats (ghee, margarine, etc) should be avoided in the diet. Avoid oily & saturated food, as the cholesterol and triglyceride levels tend to be high in patients with Nephrotic syndrome.

Meet calories requirement: You will be suggested to increase calories (yet low in fat) in children’s daily diet to conserve proteins.

Sodium restriction in diet: check on use of sodium to prevent oedema (fluid accumulation). Check for invisible source of sodium also like- Papad, Bakery products etc.

Have a glance for the food list need to be avoided and what can be given to the children.

After counselling the diet plan of Rahul, parents were also provided diet tips paper and also suggested to keep a check for the fluid restriction as suggested by the treating Doctor. The medicinal dose, diet therapy & fluid restriction helps in managing the complications related to the Nephrotic syndrome. A regular follow up with your Nutrition expert is suggested. Nutrition re-assessment will help in knowing the required nutrition is met or still needs necessary dietary modifications. The need of nutrition supplement will be advised as per the food intake of the children.

Diet tips

  1. Protein intake should be as per advice: Protein requirement may vary based on the current health of your kidneys. Follow as per the prescription.
  2. Read food labels and check sodium in the food items:
  • Limit or avoid using seasonings with “salt” in the name. These have a higher salt content than herbs and spices.
  • Buy food items with no added sodium or low sodium.
  • Low-sodium options include herbs and spices, vinegar, lemon juice.
  1. To lower cholesterol 
  • Make your child eat cereals/grains, fresh fruit and vegetables and fiber such as whole grains, fruits and vegetables can help lower cholesterol.
  • Use low fat Milk
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