Minimal Nitrogen Requirements of Children With the Nephrotic Syndrome

The appetite of patients with the nephrotic syndrome is notoriously poor. In addition to lacking a desire for food these patients are peculiarly subject to gastrointestinal upsets, which may be induced or exacerbated by forced feeding. It is especially important that nephrotic patients be maintained in nitrogen equilibrium to offset the severe malnutrition characteristic of the syndrome. Previous studies from this clinic on the capacity of nephrotic children similar in age to those used in this study to assimilate dietary protein indicated that maximum assimilation of nitrogen occurred with a diet containing 3.2 Gm. of protein per kilogram of ideal body weight (accepted average weight for height and age) when the caloric intake was liberal.¹No data were available regarding the ability of nephrotic children to maintain themselves in nitrogen equilibrium on minimum caloric and nitrogen intakes. Unpublished observations on the incidence of nephrotic crises, with and without accompanying