Successful treatment of nephrotic syndrome with a hypoallergenic diet has long been documented in several clinical studies and case reports over the past three decades. However, the use of elimination diets, such as gluten-free or dairy-free diets, in management of nephrotic syndrome has received inadequate attention from clinicians, and research on diet as a therapeutic option in nephrotic syndrome is limited.
While the mechanism is unclear, gluten-free and dairy-free diets may influence the composition and immune function of gut microbiota and decrease the risk of certain immune-mediated diseases.
However, there are currently no data on the effects of altered gut microbiota on pediatric kidney disorders, such as idiopathic nephrotic syndrome. Nevertheless, new evidence has emerged in the role of gut microbiota in progressive renal disease in adults.
More studies are needed to address the potential of using a dietary intervention, such as gluten-free or dairy-free diets, and avoiding potentially harmful and toxic immunosuppressive medications in children with difficult-to-treat nephrotic syndrome