file:///C:/Users/Jos%C3%A9%20Oliveira%20Luiz/Downloads/LivroVermelhoPlantasRarasCerrado.pdfImagem de ION DAVID da cidade de Alto Paraiso de Goias, centro de estudos socioambientais na Chapada dos Veadeiros. The Physicians Committee Make sustainable dietary changes. Sign up for the free 21 Day Vegan Kickstart. Participants receive daily messages for a step-by-step diet makeover, including recipes and nutrition webcasts. Go >Nutrition and Renal DiseaseThe kidneys job is to keep the bodys fluids, electrolytes, and organic solutes in a healthy balance. Their functional units are the million or so nephrons in the renal cortex which filter most constituents of the blood other than red blood cells and protein, reabsorb needed substances, secrete hydrogen ions to maintain acid-base balance, and secrete wastes.1Urine formation consists of three basic processes: glomerular filtration, tubular secretion, and tubular reabsorption. Several disease conditions can interfere with these functions. Inflammatory and degenerative diseases can involve the small blood vessels and membranes in the nephrons. Urinary tract infections and kidney stones can interfere with normal drainage, causing further infection and tissue damage. Circulatory disorders, such as hypertension, can damage the small renal arteries. Other diseases, such as diabetes, gout, and urinary tract abnormalities can lead to impaired function, infection, or obstruction. Toxic agents such as insecticides, solvents, and certain drugs may also harm renal tissue.Nephrotic SyndromeIn nephrotic syndrome, an injury to the glomerular basement membrane causes an increased glomerular permeability, resulting in the loss of albumin and other plasma proteins in the urine. Urinary protein losses greater than 3-3.5 grams per day usually indicate nephrotic syndrome.Although albumin synthesis in the liver is increased in nephrotic syndrome, it is not enough to compensate for losses in the urine. The loss of albumin leads to edema.Low albumin levels also trigger cholesterol and lipoprotein synthesis in the liver, resulting in hyperlipidemia. At the same time, hepatic catabolism of serum lipoproteins is reduced and urinary excretion of HDL is increased. These lipid abnormalities can be exacerbated by medications often used to treat nephrotic syndrome, such as steroids, diuretics, and anti-hypertensive agents.Diet for Nephrotic SyndromeA well-planned diet can replace lost protein and ensure efficient utilization of ingested proteins through provision of adequate calories. Dietary changes can also help control hypertension, edema, and hyperlipidemia, and slow the progression of renal disease.Protein: High-protein diets are not recommended as they may encourage damage to the nephrons, leading to a progression of renal insufficiency. Since albumin losses in nephrotic patients are due to increased catabolism, rather than a reduction in protein synthesis, low-protein diets, which decrease catabolism, may be more beneficial.2The optimal amount of dietary protein necessary to prevent protein catabolism and progression of renal disease has not been established. A common recommendation is 0.6 grams of protein per kilogram of ideal body weight, adjusted depending on the glomerular filtration rate and nutritional status, plus gram-for-gram replacement of urinary protein losses.A vegetarian diet, often used for lipid-lowering, also offers a convenient way to provide adequate, but not excessive, protein. In a 1992 study, a group of 20 nephrotic syndrome patients were put on a vegetarian diet for eight weeks. Protein intake averaged 0.7 grams per kilogram per day, which was