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Nutrition and Nephrotic Syndrome

Nutritional requirements for a child with nephrotic syndrome:

Children with nephrotic syndrome may have trouble regulating their body's water balance. This can cause fluid retention (also known as edema). The diet for a child with nephrotic syndrome may include a sodium and fluid restriction. These restrictions in the diet may help to regulate your child's fluid balance. Any food that is liquid at room temperature counts as a fluid. This includes the following:

Helpful hints for restricting your child's fluid intake:

Your child's physician will discuss with you how much fluid your child should consume on a daily basis, based on his/her medical condition. The following recommendations may help with effectively monitoring and restricting your child's fluid intake. Consult your child's physician for additional information.

Helpful fluid conversions:

Your child's physician or dietitian will advise you on how much fluid your child may have each day. This amount is usually given in ounces, cups, or cc.

1 ounce = 30cc

1 cup = 8 ounces = 240cc

1 pint = 2 cups = 16 ounces = 480cc

1 quart = 4 cups = 32 ounces = 960cc

1 tablespoon = 1/2 ounce = 15cc

1 teaspoon = 5cc

Following a low-sodium diet:

A low-sodium diet or salt restriction may be used to help prevent or reduce fluid retention in your child's body. The amount of sodium or salt allowed in your child's diet depends on your child's medical condition. Your child's physician or dietitian will determine the amount of sodium allowed in your child's diet. This is usually expressed in milligrams (mg) per day. Some common sodium restrictions include 2,000, 3,000, or 4,000 mg per day. With most sodium-restricted diets, high-sodium foods are limited and salt is not allowed in food preparation or at the table.

What foods are high in sodium?

The following foods are high in sodium and should be avoided if your child has been prescribed a low-sodium diet:

What foods are low in sodium?

What are low-sodium seasonings?

The following are considered low-sodium seasonings and do not require restriction:

allspice
bay leaf
basil
chili powder
chives
cinnamon
cloves
curry powder
dill
extracts (vanilla)
vinegar
garlic (fresh)
garlic powder
ginger
horseradish sauce
lemon juice
lime juice
mace
marjoram
dry mustard
nutmeg
Mrs. Dash®
onion (fresh)
onion powder
oregano
paprika
pepper
rosemary
sage
tarragon
thyme
Tabasco®

What seasonings are high in sodium?

The following seasonings are high in sodium, but may be used in limited amounts, in most cases:

Limit the following seasonings to 1 tablespoon per meal:

  • barbecue sauce
  • cocktail sauce
  • ketchup
  • mustard
  • hot sauce
  • low-calorie salad dressing
  • steak sauce

How can I help my child to reduce his/her salt intake?

The following recommendations may help to decrease the amount of salt in your child's diet:

Type of food

Allowed

Foods to Avoid

Milk, yogurt, cheese
  • whole, 2 percent, or skim milk
  • cottage cheese, regular hard cheeses, tofu
  • puddings, custards, ice cream
  • processed cheese, cheese spreads
Meat, fish, poultry
  • fresh or frozen meats, poultry, fish
  • low sodium canned tuna or salmon
  • dried beans and peas
  • soybean/vegetable protein
  • peanut butter
  • salted or canned meats, fish (sardines, herring, anchovies), or poultry
  • lunch meats (bologna, ham, corned beef)
  • cured meats (ham, bacon, sausage)
  • hot dogs, dried beef, jerky
  • commercially frozen entrees
  • Kosher-prepared meats
Fruits
  • fresh, frozen, or canned fruits, fruit juices
  • none
Vegetables
  • fresh, frozen, or low sodium canned vegetables
  • sauerkraut, salted or pickled vegetables
  • vegetables cooked with salted meats
  • regular vegetable juices
Starches, breads, cereals
  • potatoes, macaroni, spaghetti, noodles, rice
  • unsalted potato chips, low sodium pretzels, unsalted crackers, unsalted popcorn, and nuts
  • whole grain and enriched breads
  • pancakes, muffins, french toast, waffles, biscuits, cookies, cakes
  • whole grain and enriched cooked or commercially prepared dry cereals
  • potato chips, slated snack foods or pretzels
  • commercially prepared rice and noodle mixes
  • salted breads, rolls and crackers
  • salted popcorn and nuts
Miscellaneous
  • chocolate, cocoa, horseradish, herbs and spices such as onion powder, fresh garlic, garlic powder, celery seed
  • flavorings such as vinegar, lemon juice, Tabasco®
  • low sodium condiments and seasonings such as Mrs. Dash®, Nu-Salt®, Morton's Lite Salt®, NoSalt®
  • catsup, chili sauce, barbecue sauce, mustard, gravy (limit to 1 Tbsp/day)
  • low sodium canned soups, homemade soups
  • commercially prepared meat sauces
  • monosodium glutamate (MSG)
  • onion salt, garlic slat, celery salt, seasoned salt
  • olives, pickles
  • relish, soy sauce, Worcestershire sauce®
  • dehydrated soup or bouillon, canned soups
Fats
  • butter, margarine, lard, shortening, vegetable oil, mayonnaise
  • salad dressing (limit 1 Tbsp/day)
  • salt pork, bacon fat, fat back
  • more than 1 Tbsp salad dressing/day

Sample plan for 3,000 mg sodium restriction:

In many cases with nephrotic syndrome, your child may be placed on a 3,000 mg per day sodium-restricted diet. If this is the case, the following meal plan has been designed as an example to meet this restriction:

Breakfast Lunch Dinner
orange juice (1/2 cup)
dry cereal (1/2 cup)
toast (1 slice)
margarine (1 tsp)
jelly (1 Tbsp)
lowfat milk (1 cup)
beef patty (3 oz)
hamburger bun (1)
mustard (1 Tbsp)
ketchup (1 Tbsp)
sliced tomato and lettuce
lowfat milk (1 cup)
baked, breaded chicken strips, homemade (3 oz)
oven-baked french fries, homemade (1/2 cup)
green beans (1/2 cup)
dinner roll (1)
margarine (1 tsp)
apple juice (1 cup)
frozen yogurt (1/2 cup)
Morning snack Afternoon snack
banana
cereal fruit bar
oatmeal cookies (2)
lemonade

Definitions for sodium claims on food labels:

As you prepare foods for your child, it is important to read food labels carefully. Consider the following:

The food label reads: What this means:
Sodium-free less than 5 mg sodium per serving
Salt-free meets requirements for sodium-free
Low sodium 140 mg sodium or less per serving
Very low sodium 35 mg sodium or less per serving
Reduced sodium at least 25 percent less sodium when compared to the same product without reduced sodium
Light in sodium 50 percent less sodium per serving when compared to foods with more than 40 calories per serving or more than 3 gm of fat per serving
Unsalted; no added salt; without added salt
  • no salt is added during processing
  • the product it resembles and substitutes for is normally processed with salt

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