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Nutritional therapy for nephrotic syndrome

Dec 31, 2016
Severe edema and less urine, appropriate restrictions on drinking water; in the treatment of large doses of corticosteroids or edema, should be given a low salt diet. Protein intake in order to maintain the body's needs and the amount of urine can be lost, the former is usually one kilogram per kilogram of body weight per day. Long term excessive intake of protein, not only useless, and will increase the burden on the kidneys, resulting in increased renal damage. Should eat more vitamin rich fresh vegetables and fruits.
1 energy sufficient energy can improve the utilization rate of the protein, nitrogen ratio, =1: 200 for energy supply by 35kcal/ (kg - D).
2 protein loss due to a large number of proteins, the traditional nutritional treatment advocated a high protein diet [1.5-2.0g/ (kg * d)]. But the clinical practice proved that when the energy supply of 35kcal/d, protein 0.8-1.0g/ (kg - D) supply, albumin synthesis rate close to normal, decreased protein decomposition, hypoproteinemia improved, lowering blood lipids, can achieve positive nitrogen balance. Such as energy supply unchanged, protein supply >1.2g/ (kg * d), the rate of protein synthesis decreased, albumin decomposition increased, hypoproteinemia has not been corrected, but increased urine protein. This is because the high protein diet can cause glomerular filtration, glomerular sclerosis. High protein diet can activate the renin angiotensin system in renal tissue, which is the result of high blood pressure, high blood fat and further deterioration of renal function. Therefore, the appropriate amount of protein supply in patients with adequate energy supply conditions, should be 0.8-10.g/ (kg * D). Such as the use of very low protein diet should also add 10-20g/d essential amino acids. It is also recommended that the use of the normal protein diet [1.0g/ (kg * d)], can be added with angiotensin converting enzyme inhibitors (ACE), can reduce urinary protein, but also improve serum albumin.
3 carbohydrates should account for about 60% of the total energy.
In 4 fat high cholesterol and low protein coexist, should first correct hypoproteinemia; fat should account for less than 30% of total energy, limiting cholesterol and saturated fatty acid intake, increasing the unsaturated fatty acids and unsaturated fatty acids intake.
5 water obvious edema, should limit the amount of water. Water intake = 1 day urine output plus 500-800ml.
6 general control in the 3-5g/d, edema should be based on the total protein content of blood and serum sodium level adjustment.
7 potassium supplement potassium and potassium rich foods according to the level of blood potassium.
8 appropriate amount of vitamin C, vitamin B foods.
9 increase dietary fiber, can help reduce blood ammonia, reduce acidosis.

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