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The common pathological types of primary nephrotic syndrome in chidren are minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), membraneous nephropathy (MN), membrane proliferative glomerulonephritis (MPG), etc. Among them, the MCD is the most common type among the children accounting for about 80% and it mainly manifests as simplex nephrotic syndrome.
Since their kidneys have been damaged, there are some restrictions on the proper diets that the diseased children should pay more attention to avoid extra burdens to the kidneys.
1. Salt. In case of edema or high blood pressure or during the period of large dosage of steroid therapy, patients should have low-salt diets (the daily intake of salt should be no more than 2g). Salty foods such as pickled foods, processed foods, and scanned foods should be avoided and monosodium glutamate and base should be limited. When the edema subsidises and plasma protein recovers, the diets can be normal again.
2. Protein. Though protein is very necessary and important for maintaining normal life activities, too much intake of protein will add burdens to the kidney and aggravate the kidney damages for children with nephrotic syndrome. It is better that the daily intake of protein is 1g/kg and if there is large amount of protein leakage in urine, there can be proper increase of protein intake. High quality proteins such as fish and lean meat are good choices. However the protein intake should depend on specific illness and physical conditions. For example those that have azotemia should limit the intake of proteins.
3. Fat. Nearly all children with nephrotic syndrome have hyperlipidemia and this can cause arteriosclerosis, glomerular injury and hardening, therefore they should limit the intake of animal fats, some sea products and foods that are high in cholesterol and fat and have unsaturated fatty acid and vegetable oils instead.
4. Vitamins. Childhood nephrotic syndrome patients should have proper amount of fresh fruits and vegetables that are high in vitamins. And wax gourd and watermelon are especially conducive for those that have oliguria.
5. Trace elements. Since the permeability of the glomerular basement membrane is increased, some trace elements and hormone are lost along with the protein and there will be lack of calcium, magnesium, zinc, iron, etc. Therefore they need to supply enough foods that contain rich vitamins and trace elements such as fruits, vegetables, whole grains, etc.
In case of severe edema and decreased urine output, the water intake should be limited.
