[Lifestyle modification and diet therapy for nephrotic syndrome]

The management of the lifestyle of patients with nephrotic syndrome is important to prevent progression to end stage renal failure. In spite of various kinds of medication, the daily lifestyle and diet modification should be taken into consideration from the early stage. The strict restriction of exercise is disagreeable. However, when exercises have bad influence on the renal function, we need to restrict exercise suitably. Optimal dietary protein intake is 1.0-1.1 g/kg/day in minimal change nephrotic syndrome and 0.8 g/kg/day in other types of nephrotic syndrome. Additional protein restriction should be required for patients with renal dysfunction. Energy requirements are basically more than 35 kcal/kg/day. Salt should not be rigidly restricted and 5-7 g/day of salt may be permitted in the steady state. Moreover, the nutrition state should be evaluated by physical measurements and laboratory data, and workmanship of diet therapy should be guided.