1. Goals of Nutrition Therapy in Nephrotic Syndrome

A well-structured diet aims to:

Reduce edema (swelling)

Prevent protein malnutrition

Manage high cholesterol

Protect kidney function

Control blood pressure

Maintain electrolyte balance

These goals guide the selection of nutrients and foods.

2. Protein Intake: Moderate, Not High

People often assume that losing protein in urine means eating a lot of protein. However, too much protein strains the kidneys. The recommendation is moderate protein intake, usually 0.8–1.0 g/kg body weight/day unless otherwise directed by a clinician.

Best Protein Sources:

Skinless chicken, turkey

Fish (especially oily fish in moderation)

Eggs

Plant proteins: beans, lentils (consider potassium/phosphorus levels)

Low-fat dairy in controlled amounts

Avoid Excess:

Large amounts of red meat, processed meats, whey protein, and high-protein supplements.

3. Sodium (Salt) Restriction: Control Edema and Blood Pressure

Sodium retention worsens swelling. A low-salt diet (2 g or less per day) is key.

Strategies:

Avoid adding salt during cooking and at the table

Choose fresh foods instead of processed or canned foods

Limit salty seasonings: stock cubes, soy sauce, salted fish, processed meats

Read labels: aim for foods with <140 mg sodium per serving

Better Alternatives:

Herbs (garlic, ginger, thyme, rosemary)

Lemon juice

Fresh pepper and spices

4. Fluid Intake: Sometimes Restricted

In many patients, fluids may need to be controlled, especially if edema is severe or urine output is low. Guidance depends on individual assessment by a healthcare provider.

General tip:

Monitor swelling and follow the doctor's advice for daily fluid limits.

5. Fat and Cholesterol Control: Reduce Heart Risks

Nephrotic syndrome often raises cholesterol and triglyceride levels. A heart-healthy eating pattern helps lower cardiovascular risk.

Choose:

Healthy fats: olive oil, avocado (small amounts), nuts and seeds (as allowed)

Oily fish twice a week

Low-fat milk or plant-based alternatives

Avoid or Limit:

Fried foods

Butter, margarine, lard

Creamy soups and pastries

Fast food

6. Potassium and Phosphorus: Adjust Based on Kidney Function

If kidney function is normal, potassium and phosphorus are usually not restricted. However, if levels rise or if chronic kidney disease develops, adjustments are needed.

High-Potassium Foods to Watch (if restricted):

Banana, orange, avocado, tomatoes

Sweet potatoes, cocoyam, plantain

High-Phosphorus Foods:

Dairy

Nuts and seeds

Dark cola drinks

Organ meats

Work with a dietitian for personalized guidance.

7. Carbohydrates: Maintain Energy Without Overloading the Kidneys

Carbohydrates help meet energy needs so the body does not break down muscle for fuel.

Choose:

Whole grains (in moderation): brown rice, oats

Root crops: yam, potatoes

Fruits and vegetables (adjusted for potassium if needed)

8. Weight Management: Prevent Excess Weight Gain

Swelling can mask true weight changes. A balanced diet and physical activity (when tolerated) help control weight and prevent stress on the kidneys.

Steam, grill, or bake instead of frying

Use fresh herbs for flavor instead of salt

Portion protein moderately

Include a vegetable in every meal

Avoid over-reliance on canned or processed foods

Limit sugary snacks, pastries, and heavy creamy foods

Choose fresh fruit over juice

Breakfast

Oats cooked in water with a splash of low-fat milk

Boiled egg

Apple or pear

Lunch

Grilled chicken breast

Steamed rice

Mixed vegetables seasoned with garlic and herbs

Snack

Unsalted popcorn or fruit (as allowed)

Dinner

Baked fish with lemon and pepper

Steamed yam or potatoes

Side salad with olive oil dressing

Conclusion

Nutrition plays an essential role in managing nephrotic syndrome. By focusing on moderate protein, low sodium, controlled fats, and balanced nutrients, individuals can reduce symptoms, protect heart health, and support better kidney function. Working closely with a dietitian ensures a customized plan that fits your health status and lifestyle.