How should you eat with nephrotic syndrome?

Written by Zhang Hui
Nephrology
Updated on September 02, 2024
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Nephrotic syndrome is characterized by urine protein greater than 3.5 grams, serum albumin less than 30, the presence of edema, and hyperlipidemia. Patients matching these criteria can be diagnosed with nephrotic syndrome. From its diagnosis, we can see that such patients have a high amount of urine protein and relatively low blood protein. For these patients, it is necessary to control their protein intake, generally suitable at 0.6-0.8 grams per kilogram of body weight per day. Due to hypoalbuminemia, as the liver synthesizes protein, it also leads to an increase in blood lipids. Therefore, patients with nephrotic syndrome need to follow a low-fat diet to avoid further elevation of blood lipids. Additionally, as patients with nephrotic syndrome generally have edema, it is necessary to restrict sodium intake to prevent sodium and water retention, further aggravating the edema.

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Written by Zhou Qi
Nephrology
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Can nephrotic syndrome be clinically cured?

Nephrotic syndrome, a disease that clinically cannot be completely cured, is a chronic illness with no concept of cure. However, with appropriate treatment plans, many patients can achieve effective relief. There are two criteria for judging treatment effectiveness: first, the patient's 24-hour urinary protein quantification is controlled below 0.5 grams, and even can be controlled below 0.3 grams. Second, the patient's 24-hour urinary protein quantification is reduced by more than half compared to the baseline value. Both scenarios indicate effective treatment, but achieving a complete cure is difficult.

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Written by Li Liu Sheng
Nephrology
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How to reduce swelling in the feet caused by nephrotic syndrome?

Swelling of the feet is a common phenomenon in nephrotic syndrome. Once swelling occurs, patients feel uncomfortable symptoms and a sensation of heaviness in their feet, so corresponding de-swelling treatment is necessary. How to reduce swelling? Firstly, a low-salt diet is essential to control salt intake, with daily salt consumption around 2 to 3 grams. In addition to this, small doses of diuretics such as hydrochlorothiazide and spironolactone can be used. If the diuretic effect is not satisfactory, other more potent diuretics like furosemide may be added. Of course, the fundamental treatment for foot swelling in nephrotic syndrome involves the use of steroids and immunosuppressants. This treatment works by suppressing the permeability of the glomerular basement membrane and reducing protein leakage, thereby ultimately eliminating the foot swelling.

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Written by Zhou Qi
Nephrology
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Precursors of relapse of nephrotic syndrome

Nephrotic syndrome is characterized by patients having 24-hour urinary protein quantification exceeding 3.5g and blood plasma albumin levels lower than 30g/L. This condition can be long-lasting. Some patients, after treatment, can have their condition effectively controlled, but there is still a possibility of relapse. Such relapses often occur after the patient has been overworked or has caught a cold, but there are also some patients who do not have such triggers. When the condition relapses, the urinary protein level increases again, which might lead to an increase in urine foam. Patients might experience significant swelling in the lower limbs and face among other areas, suggesting a relapse of nephrotic syndrome, and it is important to go to the hospital for relevant tests promptly.

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Written by Zhou Qi
Nephrology
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Does nephrotic syndrome cause itchy skin?

Nephrotic syndrome generally does not cause itchy skin in patients. In patients with nephrotic syndrome, the glomerular filtration barrier is severely damaged, leading to a significant presence of urinary protein and edema, but itchy skin is a rare clinical symptom. If a patient experiences itchy skin, it is recommended to visit the dermatology department of a standard hospital. As such patients may have a disordered immune system, they are prone to various skin issues, such as allergic dermatitis and eczema, which might cause symptoms of itchy skin. However, these are not directly related to nephrotic syndrome.

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Written by Zhou Qi
Nephrology
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Is nephrotic syndrome easy to treat in children?

The diagnostic criteria for nephrotic syndrome are a 24-hour urinary protein quantification exceeding 3.5g and plasma albumin levels below 30g/l. This is due to severe damage to the glomerular capillary network, which has many pathological types since there are various components to the glomerular capillaries, and damage to different components is referred to as different pathological types. Among children, the most common pathological types are minimal change disease and mesangial proliferative glomerulonephritis. These two types are relatively easier to treat. Most children are sensitive to steroid medication. However, treatment becomes difficult with other pathological types, such as focal segmental glomerulosclerosis, which shows less sensitivity to steroids. (Medication use should be under the guidance of a doctor.)