Abstract |
The contribution of hypoalbuminemia to impaired diuretic responsiveness can be overcome by administering larger doses of loop diuretics. However, the clinical efficacy of the combination of loop-acting diuretics with human albumin remains controversial. In the study reported here, 16 children with nephrotic syndrome and refractory edema were randomized in a cross-over trial to receive either the combination of 20% human albumin and frusemide infusion (HA+FU infusion group) or frusemide infusion alone (FU infusion group). At the end of study, median urine volume was 3.27 [95% confidence interval (CI) 2.04-4.50] ml/kg per hour in the HA+FU infusion group and 1.33 (95% CI 0.79-1.88) ml/kg per hour in the FU infusion group (P = 0.01); the median daily sodium excretion was 58 (95% CI 30-366) mEq and 30 (95% CI 10-122) mEq (P = 0.08), respectively The changes in other variables included weight loss [HA+FU 5.2% (95% CI 3.1-8.8); FU 0.8% (95% CI -1.9 to 4.1); P = 0.006]; urine osmolality [HA+FU 315 (95% CI 220-426) mOsm/kg; FU 368 (95% CI 318-446) mOsm/kg; P = 0.13]; osmolal clearance [HA+FU 1600 (95% CI 916-4140) ml/day; FU 880 (95% CI 510-2105) ml/day; P = 0.01; free water clearance [HA+FU -190 (95% CI -960 to 280) ml/day; FU -162 (95% CI -446 to -70) ml/day; P = 0.18]. The findings from this study suggest that the co-administration of albumin and frusemide infusions is more effective than the administration of frusemide infusion alone in inducing diuresis and natriuresis in patients with nephrotic syndrome.
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Authors | Rajmohan Dharmaraj, Pankaj Hari, Arvind Bagga |
Journal | Pediatric nephrology (Berlin, Germany)
(Pediatr Nephrol)
Vol. 24
Issue 4
Pg. 775-82
(Apr 2009)
ISSN: 0931-041X [Print] Germany |
PMID | 19142668
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
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Chemical References |
- Diuretics
- Serum Albumin
- Furosemide
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Topics |
- Adolescent
- Child
- Child, Preschool
- Cross-Over Studies
- Diuretics
(administration & dosage, therapeutic use)
- Drug Therapy, Combination
- Edema
(drug therapy, pathology)
- Furosemide
(administration & dosage, therapeutic use)
- Humans
- Infusions, Intravenous
- Natriuresis
- Nephrotic Syndrome
(drug therapy, pathology)
- Serum Albumin
(administration & dosage, therapeutic use)
- Treatment Outcome
- Urine
- Weight Loss
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