The nephrotic syndrome is defined by hypoproteinemia(serum albumin ; below 2.5gm/dl), massive proteinuria(960mg/m?24 hrs or more).
In patients with nephrotic syndrome, albumin is occasionally administered in
association with diuretics to relieve severe edema. However, the complication associated with albumin therapy also has been recognized.
To examine the efficacy and complication of albumin and diuretic therapy, we reviewed the hospital records of 15 children(39 hospital admissions) with the diagnosis of nephrotic syndrome who were admitted to Pediatric Department of Chung Ang
University
Hospital from January 1st, 1989 to december 31st, 1993.
@ES The results were as follows:
@EN 1) Albumin and diuretic therapy resulted in a mean weight loss of 0.61±1.02kg(2.48±3.86% body weight) per infusion(p=0.0001).
2) Heart rate and respiratory rate did not change significantly during albumin and diuretic therapy in nephrotic patient(preinfusion 95.41±16.18beats per minute vs postinfusion 95.34±15.55beats per minute, p=0.8574 ; preinfusion
24.34±3.30breaths
per minute vs postinfusion 23.72±2.65breaths per minute, p=0.1053).
3) Serum albumin, serum BUN, serum Creatinine and serum sodium did not change significantly during albumin and diuretic therapy in nephrotic patient(preinfusion 1.64±0.55g/dl vs postinfusion 1.86±0.59g/dl, p=0.0876 ; preinfusion
17.74±12.90mg/dl vs
postinfusion 15.52±8.88mg/dl, p=0.3963 ; preinfusion 0.74±0.28mg/dl vs postinfusion 0.65±0.28mg/dl, p=0.2452 ; preinfusion 134.79±3.65 vs postinfusion 134.87±4.53, p=0.9249).
In summary, albumin and diuretic therapy in the treatment of edema in children with the nephrotic syndrome results in acute diuresis and fluid removal. Although we did not find the significant complication of this therapy, the beneficial effect
which
facilitate weight loss and fluid removal has to be balanced against potential complications.
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