One of the greatest challenges in practice is treating resistant nephrotic syndrome in children. Nephrotic syndrome, which features protein wasting from the kidneys, will present at any age with edema, fatigue, hypercholesterolemia, and mildly elevated blood pressure. Over time there’s a high risk of permanent kidney damage, bone degeneration, cardiovascular disease, and muscle wasting. However, with children, there is the additional problem of stunted growth and delayed puberty.
Nephrotic syndrome can directly affect growth and development as albumin is lost in the urine. Levels of peptide hormones are often significantly lower in children with nephrotic syndrome, especially thyroid hormones. There are significant decreases in serum thyroxine (T4), triiodothyronine (T3), and thyroid-binding globulin (TBG) concentrations in nephrotic children, compared with the patients in remission and age-matched controls. 1 These patients are also prone to infections, as decreased albumin will suppress the immune response. Many of these children have been placed on antibiotics repeatedly.
As calcium is bound to albumin, the loss of albumin in the urine will result in a lower serum calcium. 2 Simply adding a supplement, however, will not be especially helpful if the ability to absorb and assimilate calcium is compromised. If the proteinuria continues to progress and damage the kidneys, there will also be the added problem of elevated blood phosphorus and hyperparathyroidism that can continue to compromise the bones.
Anemia may also be a factor in delayed growth in children with chronic kidney disease. While progressed kidney disease will cause anemia as the kidneys lose their ability to produce erythropoietin, nephrotic syndrome will cause anemia with urinary losses of the hormone. 3 Anemia will also result in reduced kidney perfusion and exacerbation of cardiovascular risk factors, found in nephrotic patients of all ages. 4…
…A proper diet and supplementation can help, even in some of the most persistent cases of proteinuria. A naturopathic approach helps reduce the need for steroids but should also aim to help promote bone growth and development.
Click here to read the full article published in Naturopathic Doctors News & Reviews.
- Ito S, Kano K, Ando T, Ichimura T. Thyroid function in children with nephrotic syndrome. Pediatr Nephrol. 1994;8(4):412-415. ↩
- Butler SJ, Payne RB, Gunn IR, et al. Correlation between serum ionized calcium and serum albumin concentrations in two hospital populations. Br Med J (Clin Res Ed). 1984;289(6450):948-950. ↩
- Kaysen GA. Nonrenal complications of the nephrotic syndrome. Annu Rev Med. 1994;45(1):201-210. ↩
- Westenbrink BD, Visser FW, Voors AA, et al. Anaemia in chronic heart failure is not only related to impaired renal perfusion and blunted erythropoietin production, but to fluid retention as well. Eur Heart J. 2007;28(2):166-171. ↩