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Does albumin and
furosemide therapy affect plasma volume in nephrotic children?
Bircan Z, Kervancioglu M, Katar S, Vitrinel
A. Pediatr Nephrol 2001
Jun;16:4979
Kartal Training and Research Hospital, Istanbul, Turkey.
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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.
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