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Hypovolemia and hypovolemic shock in children with nephrotic syndrome.
Acta Paediatr Taiwan. 2000 Jul-Aug; 41(4):179-83.AP

Abstract

Hypovolemic shock is not an uncommon presentation in nephrotic syndrome, yet it is seldom mentioned in the literature. This study was performed to investigate the prevalence of hypovolemia and hypovolemic shock in the acute nephrotic stage, and the association of hemoconcentration and abdominal pain with hypovolemic status. Two hundred and twenty-five patients with a total of 328 admissions to the pediatric ward of our hospital during 1983 to 1996 were retrospectively reviewed for hypovolemic episodes. Clinical presentation and laboratory data including hemoglobin, serum sodium, albumin, cholesterol, and triglyceride levels were investigated. Thirteen patients with 19 episodes (5.8%) of hypovolemic shock were found, and had more severe hemoconcentration (hemoglobin 19.6 +/- 2.2 g/dL) and hyponatremia (127.3 +/- 7.2 mEq/L). Another 33 patients with 41 symptomatic hypovolemic episodes without hypotension (12.5%) were found, and their hemoglobin levels were higher compared to patients without hypovolemic symptoms. Among 61 episodes of abdominal pain and hemoconcentration, 58 were responsive to albumin infusion. This suggested the presence of hypovolemia. Twenty patients had abdominal pain without hemoconcentration, and 18 of them had primary peritonitis. Hypovolemia was found in patients at the acute nephrotic stage, and was usually associated with hemoconcentration and abdominal pain. A combined examination of hemoglobin and serum sodium is the best indicator of hypovolemic status. Both primary peritonitis and hypovolemic episodes should be taken into consideration when managing abdominal pain in children with nephrotic syndrome.

Authors+Show Affiliations

Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11021002

Citation

Wang, S J., et al. "Hypovolemia and Hypovolemic Shock in Children With Nephrotic Syndrome." Acta Paediatrica Taiwanica = Taiwan Er Ke Yi Xue Hui Za Zhi, vol. 41, no. 4, 2000, pp. 179-83.
Wang SJ, Tsau YK, Lu FL, et al. Hypovolemia and hypovolemic shock in children with nephrotic syndrome. Acta Paediatr Taiwan. 2000;41(4):179-83.
Wang, S. J., Tsau, Y. K., Lu, F. L., & Chen, C. H. (2000). Hypovolemia and hypovolemic shock in children with nephrotic syndrome. Acta Paediatrica Taiwanica = Taiwan Er Ke Yi Xue Hui Za Zhi, 41(4), 179-83.
Wang SJ, et al. Hypovolemia and Hypovolemic Shock in Children With Nephrotic Syndrome. Acta Paediatr Taiwan. 2000 Jul-Aug;41(4):179-83. PubMed PMID: 11021002.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hypovolemia and hypovolemic shock in children with nephrotic syndrome. AU - Wang,S J, AU - Tsau,Y K, AU - Lu,F L, AU - Chen,C H, PY - 2000/10/6/pubmed PY - 2000/10/21/medline PY - 2000/10/6/entrez SP - 179 EP - 83 JF - Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi JO - Acta Paediatr Taiwan VL - 41 IS - 4 N2 - Hypovolemic shock is not an uncommon presentation in nephrotic syndrome, yet it is seldom mentioned in the literature. This study was performed to investigate the prevalence of hypovolemia and hypovolemic shock in the acute nephrotic stage, and the association of hemoconcentration and abdominal pain with hypovolemic status. Two hundred and twenty-five patients with a total of 328 admissions to the pediatric ward of our hospital during 1983 to 1996 were retrospectively reviewed for hypovolemic episodes. Clinical presentation and laboratory data including hemoglobin, serum sodium, albumin, cholesterol, and triglyceride levels were investigated. Thirteen patients with 19 episodes (5.8%) of hypovolemic shock were found, and had more severe hemoconcentration (hemoglobin 19.6 +/- 2.2 g/dL) and hyponatremia (127.3 +/- 7.2 mEq/L). Another 33 patients with 41 symptomatic hypovolemic episodes without hypotension (12.5%) were found, and their hemoglobin levels were higher compared to patients without hypovolemic symptoms. Among 61 episodes of abdominal pain and hemoconcentration, 58 were responsive to albumin infusion. This suggested the presence of hypovolemia. Twenty patients had abdominal pain without hemoconcentration, and 18 of them had primary peritonitis. Hypovolemia was found in patients at the acute nephrotic stage, and was usually associated with hemoconcentration and abdominal pain. A combined examination of hemoglobin and serum sodium is the best indicator of hypovolemic status. Both primary peritonitis and hypovolemic episodes should be taken into consideration when managing abdominal pain in children with nephrotic syndrome. SN - 1608-8115 UR - https://www.unboundmedicine.com/medline/citation/11021002/Hypovolemia_and_hypovolemic_shock_in_children_with_nephrotic_syndrome_ L2 - https://medlineplus.gov/shock.html DB - PRIME DP - Unbound Medicine ER -