Nutrition DeptMedicine Faculty of UniversitySumatera UtaraShaped like a bean, but functions covered it all3 functions: excretory, endocrine, metabolicNephrotic syndromeAcute renal failureProgressive nature of renal disease (chronic renal disease)End stage renal diseaseenal stones!omprises a heterogeneous group of disease!ommon manifestation of "hich derive from a loss of the glomerular #arrier to protein$arge protein losses edema% hypercholesterolemia% hypercoagula#ility% and a#normal #one meta#olism &'( of the cases stem from ) systemic disease (DM% S$E% and amyloidosis) and * disease (miinimum change disease% mem#ranous nephropathy% focal glomerulosclerosis% and mem#ranoproliferative glomerulonephritis)Deteriorate is not consistent feature +#,ectives- manage the symptoms associated "ith the syndrome (edema% hypoal#uminemia% and hyperlipidemia)Decrease the ris. of progression to renal failureMaintain nutritional storesProvide su/cient protein and energy to maintain a positive nitrogen #alance and to produce an increase in plasma al#umin concentration and disappearance of edemaEnergyAdults- )' .cal0.g0day!hildren- 12231'2 .cal0.g0dayProtein eduction of protein inta.e to as lo" as 245 mg0.g0day decrease proteinuria "ithout adversly a6ecting serum al#umin'2( to 72( of protein should #e from high #iologic value (89:) Sodium $imit sodium inta.e ) g of sodium daily$ipids8ypercholesterolemia Pediatric patient premature atherosclerosis!haracteri;ed #y a sudden reduction in glomerular cess mineral% meta#olitesaccumulation Duid% "aste product (uremic to>in nausea) eE urea and minerals (F)$ipid a#normalityEndocrine- vitamin D0!a BGphospate meta#olism and 8# synthesis0 erythropoetin renal #one disease3osteodysthrophy and anaemiaeduced inta.e of SFA9ody "eight #alanced$o" cholesterolPatientsMinimum protein requirementotes Normal adults?hose "ith uncomplicated !FD247 g of protein0day )23)' .cal0.g per day needed to utilise dietary protein e/ciencyAd,ustment for speciimum neededFhosla and Mitch% European enal Disease% B22I?he "eight loss% fatiEue% and muscle "asting seen in chronic .idney disease misdiagnosed as malnutrition #ut it is the meta#olic conseEuences of !FD mucle "asting (not dietary insu/ciency)E6ectson nitrogen #alanceMitch% 1&5B% Fidney @nternational?he presence of renal (.idney) stones@ncreased almost B2 years (1&I731&&*) )45( to '4B(FreEuent occurrences ages )23'2Males () times)Ahite J 9lac. and Me>ican3Americanis. dou#le in those "ith family history of renal stonesAfter corrective treatment for medical disorders% should receive counseling for diet and Duid modicess of )22 mg0day in man and B'2 mg0day in "omen or * mg for either (random urine collection)J 522 mg animal protein$o" calcium diets prolonged damage #one fracture% osteoporosisecomm- moderate calcium restriction 522 mg0day !alcium supplement should #e ta.en "ith meals Prevent calciuria% #ind dietary o>alate% and reduce its a#sorption!alcium inta.e 1B22 mg% restrict animal protein and salt inta.e #etter than calcium restrictionD@- 1222 mg0day men% "omen age '2 years% and younger1B22 mg0day older than '2 years@ncrease ris.-Animal protein+>alateSodium:itamin !Decreased ris.-!alciumPotassiumMagnesiumFluid inta.eFi#er0phytate:itamin 978ypero>aluria- J*2 mg of o>alate in urine0day calcium stone formationNormal- 1'3*2 mg of o>alate in urine(+-!L1-')8igh in vegetarian+>alate cannot meta#oli;ed in the #ody% #ut synthesis endogenousNot avoided #ecause its content alone #ut #ioavaila#ility!alcium inta.e lo" o>alate a#s riseP+9@+?@! health promoting #eneonitor urinar) urea=alcium Normal intake?1000 mg; age @ .0 )ears1700 mg; A .0 )ears