Top Nursing Care Strategies for Henoch-Schönlein Purpura Nephritis

Henoch-Schönlein purpura nephritis (HSPN) is an immune-mediated condition that affects the kidneys following systemic vasculitis, commonly seen in children but also occurring in adults. Effective nursing care plays a crucial role in managing symptoms, preventing complications, and supporting recovery. A comprehensive care plan should include dietary modifications, infection prevention, and lifestyle adjustments tailored to individual patient needs.

Dietary Management: Avoiding Trigger Foods

One of the most important aspects of caring for HSPN patients is dietary control. Certain foods are known to trigger allergic reactions or exacerbate inflammation, potentially worsening kidney involvement. It's essential to avoid so-called "trigger" or "heat-inducing" foods such as bamboo shoots, shellfish (like shrimp and crab), mangoes, and pineapples. These items may stimulate the immune system and increase vascular permeability, which can aggravate purpuric lesions and renal symptoms.

Personalized Nutrition Based on Body Constitution

Incorporating principles from traditional medicine, patient diets can be further optimized based on their constitutional type—commonly categorized as heat, cold, deficiency, or excess patterns. For individuals presenting with signs of internal heat—such as red tongue, irritability, or dark urine—a cooling diet is recommended. This includes hydrating and detoxifying foods like water chestnuts (Chinese pear) and white mulberry root (bai maogen), which help clear heat and cool the blood.

On the other hand, patients with signs of qi deficiency or spleen weakness—manifested by fatigue, poor appetite, and loose stools—should focus on tonifying the spleen and boosting energy. Nutrient-rich, easily digestible foods such as Chinese yam (shan yao) and Codonopsis root (dang shen) are highly beneficial. These ingredients support gastrointestinal function and enhance overall resilience during recovery.

Preventing Infections and Supporting Immune Health

Infection is a major risk factor for disease flare-ups in HSPN. Even minor illnesses like sore throats, fevers, or skin infections can trigger renewed immune activity, leading to increased kidney inflammation. Therefore, strict hygiene practices, timely vaccinations (as advised by a physician), and avoiding crowded or high-risk environments are strongly encouraged.

Adequate rest is equally vital. Overexertion or chronic fatigue may impair immune regulation and delay healing. Patients should maintain a balanced routine that includes sufficient sleep, moderate physical activity (when permitted), and stress reduction techniques such as mindfulness or gentle breathing exercises.

Regular follow-ups with healthcare providers, including urine tests and blood pressure checks, allow for early detection of kidney changes. Nurses and caregivers should educate families on recognizing warning signs—such as swelling, blood in urine, or persistent fever—and seeking prompt medical attention when needed.

By combining evidence-based medical care with personalized lifestyle strategies, patients with Henoch-Schönlein purpura nephritis can achieve better outcomes and improved quality of life. A holistic nursing approach not only supports physical recovery but also empowers patients and families throughout the healing journey.