RESISTANT OEDEMA IN NEPHROTICS

Abstract

Introduction: Hypoalbuminemic nephrotics often have sufficient fluid accumulation to mandate
diuretic therapy but are often resistant to diuresis. Furosemide is one of the most effective and least toxic diuretics used
in pediatric practice. In children with different diseases who received orally or intravenously 1 to 2 mg/kg doses of
furosemide. In a country like Pakistan, such a treatment is not always afforded, albumin being quite costly. Objective:
To compare the efficacy of albumin furosemide combination infusion to the infusion of furosemide alone in patients of
nephrotic syndrome with resistance oedema. Study design: Two way crossover study. Setting: Paediatric Medicine,
Nishtar Medical College, Multan. Duration: From January 2004 to June 2005. Patients and Methods:10 children.
Results: There was marked improvement in the symptoms like respiratory distress and oedema in both the groups.
Urine output was markedly increased without any significant changes in the BUN, serum creatinine, serum electrolytes
and serum calcium. These values were slightly higher in group-I but not statistically significant. No adverse effects like
drowziness confusion, hypotension and seizures were observed in any group. Conclusion: During the clinical
management of resistant oedema in nephrotics, furosemide infusion alone is as efficacious in reducing the oedema
as albumin furosemide mixtures without any adverse effects and is much more economical.