High plasma aldosterone is associated with a risk of reversible decreased eGFR in childhood idiopathic nephrotic syndrome.
نویسندگان
چکیده
BACKGROUND Oedema formation in nephrotic syndrome (NS) may be associated with volume overload or volume contraction. The present study investigates if plasma aldosterone was related to a clinical course symptomatic of either volume expansion or hypovolaemia. METHODS Twenty patients with NS were included. Blood and urine samples were collected before treatment of NS and at stable remission. Aldosterone and other vasoactive hormones were measured in plasma and the patients were classified based on the aldosterone concentrations. RESULTS Five patients were classified with stimulated aldosterone, mean 611 pg/mL [95% confidence interval (CI): 365-993], 12 with suppressed aldosterone, mean 13 pg/mL (95% CI: 6-26), and 3 with unchanged aldosterone, mean 117 pg/mL (95% CI: 101-135). Patients with high aldosterone were characterized by lower estimated glomerular filtration rate (eGFR) (87 ± 30 versus 142 ± 30, P < 0.01), and increased albuminuria (14 ± 11 versus 6 ± 4 g/L, P = 0.03) compared with the remaining patients. eGFR was normalized rapidly by volume expansion in four of these five patients. CONCLUSIONS Elevated plasma aldosterone during NS may be associated with a risk of temporary reduced eGFR. The normalization of eGFR by volume expansion supports the hypothesis of functional hypovolaemia in some patients. Our data suggest that acute measurement of aldosterone may have implications for the management of oedema.
منابع مشابه
Comparison of Daily versus Every Other Day Treatment Regimen of Levamisole to Control Recurrence in the Childhood Idiopathic Nephrotic Syndrome
Background Idiopathic nephrotic syndrome is a kidney involvement that causes edema and heavy proteinuria with severe complications if the treatment is started late. The present study aimed to assess the efficacy of Levamisole in the daily versus every other day treatment regimen to control recurrence in Childhood Idiopathic Nephrotic Synd...
متن کاملUnexpected Maternal Convulsion: An Idiopathic Case of Posterior Reversible Encephalopathy Syndrome after Delivery
Posterior reversible encephalopathy syndrome (PRES) is associated with various clinical manifestations such as headache, blurred vision, confusion and tonic-clonic convulsion. Some of the predisposing factors for PRES include hypertensive encephalopathy, preeclampsia and eclampsia, lupus erythematosus, thrombotic thrombocytopenic purpura and long-term use of immunosuppressive drugs. This condit...
متن کاملRelationship of Renal Cortical Echogenicity in Renal Ultrasonography with Course of Disease in Children with Idiopathic Nephrotic Syndrome
Background It is important to find a predictor for the course of Idiopathic Nephrotic Syndrome for better planning of treatment. Renal cortical echogenicity in ultrasonography has been postulated as a marker for the course of renal disease. The present study aimed at evaluating the relationship between renal cortical echogenicity and the course...
متن کاملگلومرولونفریت مزمن ایدیوپاتیک و حاملگی
The effect and outcome of pregnancy in patients with chronic idiopathic glomerulonephritis was studied. The study population consisted of 98 patients. All patients were divided into 8 groups according to presence, absence or coexistence of 3 general risk factors such as hypertension, renal failure and nephrotic syndrome. The adverse effect of renal disease and risk factors on the outcome of pre...
متن کاملRELAPSE RATE IN DAILY SINGLE-DOSE PREDNISOLONE THERAPY FOR CHILDREN WITH PRIMARY NEPHROTIC SYNDROME
Most current references recommend divided doses of prednisolone for the initial treatment of idiopathic minimal change nephrotic syndrome in children, with relapse occuring in the majority of them, but there is little experience concerning single-dose prednisolone therapy, especially considering the relapse rate. In this prospective study on 36 consecutive children with primary nephrotic s...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
دوره 28 4 شماره
صفحات -
تاریخ انتشار 2013