FSGS is one major cause of adult renal failure and it is the second leading cause of renal failure in children patients following Minimal Change Disease. Each year, more than 5400 patients are diagnosed with FSGS. It is estimated that about 19, 306 renal failure cases are caused by FSGS and the number is on the rise. Half FSGS patients will progress into end stage renal disease due to poor response to steroids treatment and dialysis will be offered.
Proper diets are very necessary for slowing down illness progression and protecting residual kidney functions as well as alleviating symptoms and discomforts caused by both FSGS and dialysis.
End stage FSGS patients will have proteinuria, hypoalbuminemia and hyperlipidemia due to long term metabolic disorder of protein and fat. Long term protein loss in urine can cause malnutrition, pediatric growth retardation; loss of immune globulin can cause low immunity and frequent infections.
Therefore patients should supply some proteins to make up the lost proteins in urine. However, it has been confirmed that too much protein intake will definitely increase strain to the kidneys and worsen renal damages. Low-protein diet is recommended. Daily protein intake is 1.2-1.4g/kg for those that are on adequate dialysis.
To ensure a low-protein diets and at the same time preventing malnutrition, patients can have small amount but high-quality proteins which produce fewer metabolic wastes after being absorbed.
Ketosteril can also be prescribed because it can provide essential amino acids without producing uremic wastes.
Hyperlipidaemia can increase blood viscosity, promote thrombus and increase the risk of cardiovascular complications. It can promote glomerular sclerosis and tubule-interstitial lesions and worsen illness conditions of FSGS.
Therefore FSGS patients should limit high-fat foods. Since protein and fat intake are limited, patients should have adequate heat supply (30-35cal/kg).
FSGS patients with or without dialysis often have hypertension and edema, limiting salt intake can help control fluid overload and high blood pressure. Low-salt diet is also good for protecting blood vessels. If patients have no urine output, daily salt intake should be controlled less than 1-2g.
Fruits and vegetables are good for FSGS patients especially vitamin B. During dialysis, a lot of water-soluble vitamins will be lost, therefore it is necessary to have proper supplement through diets or drugs.
Besides, FSGS patients on dialysis should limit the intake of potassium and phosphorus. Monitor fluid intake especially water and ensure that body weight gain is less than 4% between intervals of 2 dialysis.
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