title: Role of sodium during formation of edema in children with nephrotic syndrome.
abstract: BACKGROUND
  The pathogenesis of edema in nephrotic syndrome is not entirely understood. The aim of this study was to contribute to the discussion on edema pathogenesis in nephrotic syndrome by following changes in volume and sodium retention for the course of the disease in children with steroid-sensitive nephrotic syndrome (SSNS).
  
  
  METHODS
  Forty-one children with SSNS were included in the study. The patients were divided into three groups (group I: relapse-edematous; group II: relapse-edema free; group III: remission). We investigated the value of the significance and area of sodium retention and vasoactive hormones. In addition, we measured parameters such as inferior vena cava collapsibility index, left atrium diameter, and total body water (TBW) to determine the volume load and cause of edema in children with SSNS.
  
  
  RESULTS
  TBW increased in the relapse-nephrotic syndrome group and the difference was statistically significant among groups (P < 0.001). However, inferior vena cava collapsibility index and left atrium diameter were not different among groups. Fractional sodium excretion was lower in children with relapse nephrotic syndrome (P < 0.05).
  
  
  CONCLUSIONS
  Although TBW increases in children with SSNS, intravascular volume is normal. In addition, hypoalbuminemia and sodium retention of the proximal tubule cause edema in children with SSNS.
authors.affiliation: Division of Pediatric Nephrology, Faculty of Medicine, Firat University, Elaziğ, Turkey. mkgurgoze@yahoo.com
authors.forename: Metin Kaya
authors.initials: MK
authors.lastname: Gurgoze
authors.forename: Zubeyde
authors.initials: Z
authors.lastname: Gunduz
authors.forename: Muammer Hakan
authors.initials: MH
authors.lastname: Poyrazoglu
authors.forename: Ismail
authors.initials: I
authors.lastname: Dursun
authors.forename: Kazim
authors.initials: K
authors.lastname: Uzum
authors.forename: Ruhan
authors.initials: R
authors.lastname: Dusunsel
mesh_terms: D000418:Albumins / Q000378:metabolism; D000450:Aldosterone / Q000097:blood; D009320:Atrial Natriuretic Factor / Q000097:blood; D001810:Blood Volume; D001834:Body Water; D002648:Child; D002675:Child, Preschool; D018618:Echocardiography, Doppler, Color; D004487:Edema / Q000209:etiology* / Q000378:metabolism; D005260:Female; D006325:Heart Atria / Q000033:anatomy & histology; D006801:Humans; D008297:Male; D009404:Nephrotic Syndrome / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D012008:Recurrence; D012083:Renin / Q000097:blood; D012964:Sodium / Q000378:metabolism*; D014682:Vena Cava, Inferior / Q000502:physiology
chemical_list: D000418:Albumins; D000450:Aldosterone; D009320:Atrial Natriuretic Factor; D012964:Sodium; D012083:Renin