title: A critique of the overfill hypothesis of sodium and water retention in the nephrotic syndrome.
abstract: Recent reviews have claimed that the majority of patients with the nephrotic syndrome have plasma volume expansion (that is, they are overfilled). Here we attempt to re-establish balance to the debate on body fluid volume status in nephrotic patients by: (a) discussing the conflicting literature on plasma volume measurements in the nephrotic syndrome; (b) providing alternate explanations for data purporting to support an overfill hypothesis in the nephrotic syndrome; (c) emphasizing secondary neurohumoral responses that support underfilling at least as frequently as overfilling; and (d) emphasizing the clinical importance of fluid assessment in the individual patient with the nephrotic syndrome particularly in relation to diuretic use.
authors.affiliation: Department of Medicine, University of Colorado School of Medicine, Denver, USA. Pat.Knox@UCHSC.edu
authors.forename: R W
authors.initials: RW
authors.lastname: Schrier
authors.forename: R G
authors.initials: RG
authors.lastname: Fassett
mesh_terms: D000450:Aldosterone / Q000502:physiology; D000818:Animals; D001127:Arginine Vasopressin / Q000502:physiology; D004195:Disease Models, Animal; D004487:Edema / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008954:Models, Biological; D009404:Nephrotic Syndrome / Q000150:complications* / Q000503:physiopathology; D010953:Plasma Volume; D012084:Renin-Angiotensin System / Q000502:physiology; D012964:Sodium / Q000378:metabolism*; D013564:Sympathetic Nervous System / Q000503:physiopathology; D014883:Water-Electrolyte Imbalance / Q000209:etiology* / Q000503:physiopathology
chemical_list: D001127:Arginine Vasopressin; D000450:Aldosterone; D012964:Sodium