DIET THERAPY FOR PEOPLE WITH DISEASES OF THE KIDNEY: NEPHROSIS
The nephrotic syndrome includes lipoid nephrosis, a rare disease in young children, and the nephrotic phase in some patients with glomerulonephritis. The symptoms characteristic of this syndrome include severe edema, heavy albuminuria, very low serum proteins – especially albumin, high serum lipids – especially cholesterol, anemia, and oliguria.
The diet should furnish sufficient calories for maintenance of weight in adults and normal growth in children. The protein intake needs to be liberal in order to compensate for the large losses in the urine and to correct the level of blood albumin. Many physicians recommend up to 120 gm protein per day for adults and 3 to 4 gm protein per kg for young children.
Medical opinions differ on sodium restriction; some recommend 1000 to 2000 mg sodium if there is severe edema. It is questionable whether severe sodium restriction is of any value if it means that the patient will not eat. Cholesterol restriction is set at 300 mg daily by some physicians, while others do not restrict the cholesterol intake.
High-protein diet
As in all therapeutic diets, the planning for high protein intake begins with the normal diet. The basic diet outlined on p. 37 furnishes about 70 gm protein. To achieve a level of 120 gm protein means that concentrated sources of protein would be useful so that there is not excessive bulk to be consumed. If the patient likes meat, fish, or poultry the modest amounts m the basic diet may be increased by 2 or 3 ounces.
Additional milk is usually included. One way to increase the protein in the diet at low cost and with little increase in volume of the diet is to use nonfat dry milk. Depending upon the brand used, 4 to 5 tablespoons added to 8 oz milk will double the amount of protein. Nonfat dry milk may also be added to mashed potatoes, cream sauces, cream soups, baked custard, and other foods.
Many patients who require a high-protein diet have poor appetites. It is better to start with the patient’s present food intake and to gradually increase the protein and calorie intake. The portions served should be of such size that the patient is able to eat all the foods offered. A bedtime snack is a good way to increase protein and calorie intakes. Two examples of such snacks are:
Sandwich High-protein milk shake (tall glass)
2 slices bread 1 cup milk
2 teaspoons butter, mayonnaise 4-5 tablespoons nonfat dry milk
1 1/2 oz. roast beef 2 tablespoons chocolate syrup
1 oz cheese
Milk, 1 cup Protein, 16 gm; calories, 345
Protein, 29 gm; calories, 585
*151/234/5*
GENERAL HEALTH
