[Evidence-based therapy of nephrotic edema].
OBJECTIVE
To study the evidence-based therapy of edema in nephrotic syndrome by analyzing the literatures systematically.


METHODS
The literatures related to the treatment of nephrotic edema were retrieved from the following: Chinese Biological Medicine Database (CBM-disk), Chinese Journals Full-text Database (CNKI, 1994-2006), Chinese Technological Periodicals Database (VIP, 1989-2006), Chinese Evidence Biological Medicine/Cochrane Central Database (CEBM/CCD), Cochrane Library Database, MEDLINE (1966-2006), EMBASE (1975-2006), MEDLARS, SCI (1985-2006) and OVID by electron and craft search with the following key words: nephrotic syndrome, edema, recalcitrant edema, refractory edema or resistant nephrotic edema, and treatment, diuretic therapy or human albumin treatment. The relevant literatures on randomized controlled trials (RCT) that met the criteria were statistically analyzed by the Coorporative network software RevMan 4.2.


RESULTS
A total of 113 articles were searched (60 in Chinese and 53 in English), of which 12 were RCT. Three of the 12 articles were included for Meta analysis. Meta analysis showed that dextran-40 together with furosemide was effective for nephrotic edema. Human albumin solution could be used in nephrotic edema patients with coexistent severe hypoalbuminemia. A combination of diuretics by intravenous drip infusion was effective for diuretic-resistant nephrotic edema.


CONCLUSIONS
The treatment for nephrotic edema should be individualized. The evidence of treatment of nephrotic edema has not been fully elucidated. Further multicentre, large sample, and randomized controlled trials are needed.
Liu
Xi-Hong
XH
Department of Pediatric Nephrology, Second Xiangya Hospital, Central South University, Changsha, China.
Yi
Zhu-Wen
ZW
Chen
Dan
D
Zeng
Xue-Qi
XQ
Huang
Dan-Lin
DL
Jiang
Yi
Y
D004487:Edema / Q000628:therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D015201:Meta-Analysis as Topic; D009404:Nephrotic Syndrome / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic