Question

Jill Stevens is a 58 year old patient with type 1 diabetes mellitus. She was diagnosed with diabetes in her 20s and has had difficulty controlling her blood sugar, particularly for the last 5 years due to issues with health insurance and other financial concerns, as well as lack of motivation. She currently presents with hypoalbuminemia, edema, and a distended abdomen. The physician diagnoses her with nephrotic syndrome.

1. What is physiologically causing the stomach distention?
2. What is the connection between uncontrolled diabetes mellitus and nephrotic syndrome?
3. What nutritional recommendations would you make for Jill? What is the reasoning behind these recommendations?
4. What other biological tests would you recommend in order to monitor her condition?

Answer 1

Nephrotic syndrome is a kidney disorder that causes your body to pass too much protein in your urine.Ascites is a common complication in disorders that involve proteinuria, such as nephrotic syndrome. In ascites, fluid accumulates inside the abdominal cavity, causing the abdomen to distend.

Diabetic nephropathy is glomerular sclerosis and fibrosis caused by the metabolic and hemodynamic changes of diabetes mellitus. It manifests as slowly progressive albuminuria with worsening hypertension and renal insufficiency.Diabeticnephropathy is the most common cause of nephrotic syndrome

A healthy diet for Nephrotic Syndrome patients consists of low salt, low fat and low cholesterol, with emphasis on fruits and vegetables.

• Low sodium (salt) – helps with swelling in the hands and legs
• Lots of fresh fruit and vegetables – fiber such as whole grains, fruits and vegetables can help lower total and LDL cholesterol
• Lean cuts of meat, less red meat, more chicken and fish
• fluids should be restricted, as determined by a nephrologist

biological tests :

Diagnostic studies for nephrotic syndrome may include the following:

• Urine Studies
• Renal Biopsy
• Laboratory Studies
• Histologic Findings
• Ultrasonography