Does albumin and furosemide therapy affect plasma volume in nephrotic children?

Abstract

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.