Nephrotic Syndrome Diet and its Complications

Nephrotic syndrome is a kidney disorder characterized by the excessive release of protein into the urine. If you have foamy urine, it is an indication of the leaking protein in urine. This results in reduced protein levels in the blood and disrupts the body's water balance. Although diet is not a direct cause of nephrotic syndrome, it is worth noting that certain dietary choices can aggravate symptoms and potentially lead to other complications, such as high blood pressure, renal insufficiency, and increased levels of cholesterol in the bloodstream.  

Influence of dietary choices on nephrotic syndrome

It is crucial to adjust one's eating habits in order to safeguard the kidneys from damage. Although some people may try to compensate for protein loss by consuming a protein-rich diet, this is not recommended for individuals with nephrotic syndrome. Consuming excessive amounts of protein can be detrimental as it can impair the nephrons, which are the kidneys' functional units, and may result in renal insufficiency. It is advisable to have protein intake adjusted as per age and condition. To determine the specific dietary requirements for an individual, it is recommended to consult a doctor or a registered dietitian. A moderation in salt intake is strongly advised for individuals with nephrotic syndrome. Excessive sodium consumption can lead to increased fluid and salt retention, which can result in swelling and high blood pressure (hypertension). Furthermore, as this condition can also lead to elevated levels of cholestrol in the blood; so avoiding fried food, trans fats, and excess saturated fat can help in maintaining irregularities in check. In order to effectively manage this condition, it is crucial to have a clear understanding of the foods that should be included in one’s diet and those that should be avoided.

Food choices for individuals following a nephrotic syndrome diet

The management of nephrotic syndrome heavily relies on the dietary choices of the individual. Foods that can be included are:

• (In suggested amounts only) Lean meats such as poultry, fish (avoid dried fish)
• Wholesome beans
• Soybeans
• Fresh fruit including apples, watermelons, pears, oranges, bananas
• Fresh vegetables
• Rice
• Whole grains
• Unsalted nuts and popcorn
• Cottage cheese
• Milk and curd

Food to avoid while following a nephrotic syndrome diet

Individuals with nephrotic syndrome should avoid the following foods:

• Processed cheese
• High-sodium meats such as sausages
• Frozen, ready-to-eat meals
• Canned meats 
• Pickles,bakery food, fast food
• Salted snacks

In order to reduce salt intake, it is advisable to opt for low-sodium alternatives such as herbs and spices, vinegar, lemon juice, and seasoning blends with no or low sodium. Children who suffer from nephrotic syndrome may encounter difficulties in maintaining their body's fluid balance. As a consequence, they may experience fluid retention, also known as edema. Thus, only in cases with this condition, it becomes necessary to implement dietary restrictions that involve limiting the intake of salt (sodium) and fluids. By adhering to these restrictions, it becomes possible to regulate the child's fluid balance effectively. It is important to note that any food that is in a liquid state at room temperature should be considered as a fluid. This includes various items such as milk, water, juice, soda, and other beverages, as well as ice cubes, ice cream, sherbet, curds and buttermilk, ice candies, soup, and pudding.

Dietary strategies to manage nephrotic syndrome

Maintaining a healthy diet can be a challenge, but it can also be a crucial step in managing nephrotic syndrome symptoms and improving overall health. To make dietary changes more feasible, here are some useful tips to keep in mind.

• Take note of the protein intake. For nephrotic syndrome, the recommended protein is as per the age and body weight and current condition on the disease.
• Limit sodium intake as per the prescription of your healthcare team.
• Check food labels for sodium content before purchasing food items and avoid processed foods.
• Avoid using seasonings with "salt" in the name and substitute with herbs and spices instead.
• Prepare meals at home to control sodium intake.
• Choose healthy oils like olive oil, oils rich in PUFA when cooking.
• Remove salt from the dinner table to avoid overconsumption.
• Opt for fresh vegetables. and avoid salted and canned vegetables.

Complications of nephrotic syndrome

Failure to adhere to these dietary guidelines may result in complications. If not treated promptly, nephrotic syndrome can result in the following complications:

• Dehydration can lead to a decline in blood volume as a result of inadequate protein levels. In severe situations, intravenous fluids may be administered to boost the body's water content.
• Blood clots can develop in the veins of the legs or less commonly, in the veins of the kidneys. In some cases, these blood clots can travel to the lungs, resulting in symptoms such as chest pain, difficulty in breathing, or coughing up blood.
• Infection and inflammation (peritonitis) within the peritoneal cavity. This cavity is a thin and elastic lining that encloses vital organs such as the pancreas, stomach, intestines, liver, gallbladder, and more. Having fever is a potential sign of an infection.
• High blood pressure may be caused due to the buildup of extra body fluid.
• Anemia may occur as a result of excessive urinary losses of iron, transferrin, erythropoietin, etc.

 A group of symptoms that indicate an inadequate kidney functioning is known as nephrotic syndrome. These symptoms include an excessive amount of protein in urine, a lack of protein in blood, an elevated level of fat or cholesterol in blood, and swelling. Adhering to dietary recommendations can assist in effectively monitoring and minimizing the symptoms of the nephrotic syndrome. If your child is having a hard time having food while dealing with kidney problems, you can contact our expert Dieticians for a personalized diet plan.  NU Hospitals in Bangalore, India, is a specialized care hospital that prioritizes nephrology and urology. It offers an exceptional combination of state-of-the-art facilities and advanced technology to provide top-notch medical services to patients suffering from kidney disorders.

References:

1. Nutrition and Nephrotic Syndrome. Stanford Medicine. https://www.stanfordchildrens.org/en/topic/default?id=nutrition-and-nephrotic-syndrome-90-P03099.
2. Nephrotic Syndrome. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/5989-nephrotic-syndrome#management-and-treatment.
3. Nephrotic syndrome treatments, causes & symptoms. American Kidney Fund. https://www.kidneyfund.org/all-about-kidneys/other-kidney-problems/nephrotic-syndrome-treatments-causes-symptoms#is-there-a-special-diet-for-nephrotic-syndrome.
4. Nephrotic Syndrome. NATIONAL KIDNEY FOUNDATION. https://www.kidney.org/atoz/content/nephrotic.

Author: Dr. Nitin Nayak & Dt. Suneetha Rao