Does albumin and furosemide therapy affect plasma volume in nephrotic children?
Albumin infusions transiently increase plasma volume (PV) and oncotic pressure, and may restore diuretic responsiveness in nephrotic edema. To determine if albumin and furosemide therapy have an effect on PV in nephrotic children, 14 severely edematous children with minimal change nephrotic syndrome were evaluated with standard clinical parameters (heart rate, blood pressure, body weight, pretibial edema, abdominal circumference) and echocardiography [inferior vena cava index (IVCI), inferior vena cava collapsibility index (IVCCI)] before, 1 h and 24 h after albumin (20%, 0.5 g/kg, 1 h) and furosemide (2 mg/kg, i.v.) therapy. An increase in IVCI (P < 0.05), decrease in IVCCI (P < 0.05), edema (P < 0.005), and hematocrit (P < 0.005) were statistically significant 1 h after albumin and furosemide therapy, with a transient effect 24 h later. Body weight (P < 0.005), abdominal circumference (P < 0.05), and edema (P < 0.005) decreased significantly at 24 h. It is concluded that albumin and furosemide therapy increases PV transiently in nephrotic edema, returning to baseline values at 24 h with a decrease in body weight, abdominal circumference, and edema.
Bircan
Z
Z
Kartal Training and Research Hospital, Istanbul, Turkey. zbircan@superonline.com
Kervancioğlu
M
M
Katar
S
S
Vitrinel
A
A
D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D004487:Edema / Q000209:etiology; D005260:Female; D005665:Furosemide / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009404:Nephrotic Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*; D010953:Plasma Volume / Q000187:drug effects*; D012709:Serum Albumin / Q000627:therapeutic use*; D013997:Time Factors
D012709:Serum Albumin; D005665:Furosemide