How to treat nephrotic syndrome with diet

  Due to gastrointestinal mucosal edema and ascites in patients with nephrotic syndrome, digestion and absorption are affected. An easily digestible, light, semi-liquid diet should be eaten.  The patient’s diet should be light. During high-dose hormone therapy or with edema, it is advisable to give a low-salt diet, and the daily intake of sodium chloride should be 2 to 3 grams. Patients may also consume low-sodium salt. During the low-salt diet, avoid eating salted duck eggs, salted eggs, pickled vegetables and other pickled foods. After salt restriction, it is advisable to use salt-free soy sauce, vinegar, ginger, garlic, sugar and other condiments to enhance appetite. Use MSG and food alkali as little as possible. Avoid excessive restriction of sodium intake. After excessive sodium restriction, patients often lose their appetite due to tasteless diet, which affects the intake of protein and calories and affects the nutritional status of patients. Long-term excessive sodium restriction can also lead to hyponatremia, causing weakness, nausea, drowsiness, muscle cramps, hypotension, hypovolemia, postural hypotension and impairment of renal function. Since the syndrome is in negative nitrogen balance, indicating that the disease is in a protein malnutrition state, on the basis of which if drugs promoting albumin synthesis such as Astragalus and Angelica combination are given, plasma albumin can be maintained near normal levels without a decrease in urinary protein. Therefore, it can be considered that in the early, extreme stage of nephrotic syndrome, giving higher protein intake (1-1.5g/kg-d) can help to alleviate hypoproteinemia and some comorbidities caused by it. However, for chronic, non-polar nephrotic syndrome protein intake is appropriate to give a normal amount of 0.8-1.0g/kg-d of high quality protein diet. High-quality protein refers to protein that contains high essential amino acids and produces less nitrogenous substances after decomposition in the body, with high bioavailability and high nutritional value, including animal high-quality protein, such as eggs, milk, lean meat, etc., and vegetable high-quality protein, such as soybean products. Soy products are not only lower in cholesterol and phosphorus, but also rich in unsaturated fatty acids and essential amino acids, which can reduce urinary protein excretion and glomerular hyperfiltration in patients with nephropathy. Patients with nephrotic syndrome are advised to adopt a diet with an appropriate ratio of animal and plant proteins (3:2 ratio of animal to plant proteins). Although patients with nephrotic syndrome lose a large amount of urine protein and have low plasma protein, the intake of high protein can lead to an increase in urine protein and aggravate glomerular damage, while plasma protein does not increase. Therefore, it is generally no longer advocated for application. Excessive restriction of protein intake is contraindicated, which will lead to caloric deficiency and protein deficiency, aggravate malnutrition, cause decrease of body resistance and hypoproteinemia, and easily co-infection, aggravate the condition and lead to deterioration of renal function.  When accompanied by hyperlipidemia, it is advisable to limit the content of saturated fatty acids in the diet. Avoid diets rich in saturated fatty acids (animal fats and oils), it is advisable to eat a diet rich in polyunsaturated fatty acids (such as vegetable oils, fish oils) and soluble fiber (such as oats, rice bran and beans). Avoid eating fried foods.  For severe edema with little urine, it is advisable to restrict water intake appropriately to the previous day’s urine volume plus 500 ml. Avoid extreme water restriction, which can cause a drop in circulating blood volume and even dehydration and requires attention.  It is advisable to supplement vegetables and fruits and other foods rich in trace elements. It is advisable to ensure adequate calories, which should not be less than 30-35kcal per kg of body weight per day. when accompanied by anemia, it is advisable to supplement foods rich in iron, vitamin B12, folic acid, etc., such as fungus, spinach, etc. Those with obvious swelling should eat more radish, winter melon, watermelon, black beans, loofah, etc. Those with hypertension should eat celery, spinach, fungus, bean sprouts, corn, etc. For those with hematuria, lotus root, white fungus root, peanuts and eggplant are recommended. When urine is low and blood potassium is high, avoid foods containing high potassium, such as mushrooms, purple cabbage, potatoes, soybeans, orange juice, etc. People with hyperlipidemia should eat garlic (1 to 2 pieces of sweet and sour garlic in the morning on an empty stomach), ginger, eggplant, hawthorn, persimmon, black fungus, milk, onion, kelp, corn, etc.