What vitamin deficiencies are important to address in nephrotic syndrome management?

In the management of nephrotic syndrome, addressing vitamin D and calcium deficiencies is crucial. Nephrotic syndrome is characterized by significant protein loss in urine, which often leads to a decrease in vitamin D binding protein, subsequently resulting in vitamin D deficiency. This deficiency can impair calcium absorption from the intestines and may lead to secondary hyperparathyroidism, bone disease, or osteoporosis.

Calcium is essential in maintaining bone health and preventing complications such as fractures, particularly in patients who may have changes in bone metabolism due to kidney disease and steroid therapy, which is often part of nephrotic syndrome management.

In contrast, deficiencies in vitamins such as A and B12, C and E, or folic acid and iron, while potentially significant in other contexts, are not as critical to address specifically in nephrotic syndrome due to their lesser role in the immediate management of the renal and metabolic issues associated with this condition.