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Nephrotic syndrome in children

Q: My three and a half years old son is suffering from nephrotic syndrome. He started taking Prednisolone and is continuing to take 10 mg twice a day. His urine protein is nil since a week after starting the medicine and the body swelling has gone. Till date he was advised to take salt free diet and no fruit (especially juicy ones, because of potassium content, as per the doctor). From today we have started giving just little bit of salt. My question is, what is the dietary advice for him right now? Can he start taking fruits? If yes, then what kind of fruits and how much daily? What are the precautions we should while giving him Prednisolone? Are there any perceptible side-effects?

A:A high energy, high protein, low sodium diet is prescribed for a patient suffering from nephrotic syndrome. In practical terms, it is difficult to increase the protein content of the diet, as the foods that are high in protein of good quality also contain moderate to high content of sodium. Protein supplements may also be given but as advised by the doctor. Salt should be avoided in cooking as well as at the table. Food cooked without salt is not very palatable, so herbs, lemon, pepper, onion and garlic can be used to improve the flavour and taste of the food. Amongst fruits he can take apples, orange, papaya, pineapple and grapes. In reference to the second part of your query, Prednisolone is a steroid which requires to be taken under medical supervision. The patient requires a close supervision as abrupt cessation of the drug may be dangerous. The main precaution needed is to take it after meals (usually breakfast), and never take it empty stomach. It may be combined with antacids to reduce the side-effect of gastritis.

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