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Serum osmolal gap in patients with idiopathic nephrotic syndrome and severe edema.
Pediatrics. 2007 Jun; 119(6):e1404-7.Ped

Abstract

Pseudohyponatremia in idiopathic nephrotic syndrome with severe edema is attributed to hyperlipidemia that results in displacement of a portion of water phase of plasma. Current methods of measurement of serum electrolytes are unaffected by hyperlipidemia. In this report we demonstrate that patients with idiopathic nephrotic syndrome with severe edema and true hyponatremia may have an increased rather than normal osmolal gap. We believe that this could be secondary to non-Na+ and non-K+ osmoles in response to plasma-volume contraction secondary to hypoalbuminemia. This observation has implications for management of severe edema in such patients, because fluid restriction could increase their risk for pre-renal failure.

Authors+Show Affiliations

Division of Nephrology and Hypertension, Children's Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Blvd, Detroit, MI 48201, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17485452

Citation

Kapur, Gaurav, et al. "Serum Osmolal Gap in Patients With Idiopathic Nephrotic Syndrome and Severe Edema." Pediatrics, vol. 119, no. 6, 2007, pp. e1404-7.
Kapur G, Valentini RP, Imam AA, et al. Serum osmolal gap in patients with idiopathic nephrotic syndrome and severe edema. Pediatrics. 2007;119(6):e1404-7.
Kapur, G., Valentini, R. P., Imam, A. A., Jain, A., & Mattoo, T. K. (2007). Serum osmolal gap in patients with idiopathic nephrotic syndrome and severe edema. Pediatrics, 119(6), e1404-7.
Kapur G, et al. Serum Osmolal Gap in Patients With Idiopathic Nephrotic Syndrome and Severe Edema. Pediatrics. 2007;119(6):e1404-7. PubMed PMID: 17485452.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum osmolal gap in patients with idiopathic nephrotic syndrome and severe edema. AU - Kapur,Gaurav, AU - Valentini,Rudolph P, AU - Imam,Abubakr A, AU - Jain,Amrish, AU - Mattoo,Tej K, Y1 - 2007/05/07/ PY - 2007/5/9/pubmed PY - 2007/7/10/medline PY - 2007/5/9/entrez SP - e1404 EP - 7 JF - Pediatrics JO - Pediatrics VL - 119 IS - 6 N2 - Pseudohyponatremia in idiopathic nephrotic syndrome with severe edema is attributed to hyperlipidemia that results in displacement of a portion of water phase of plasma. Current methods of measurement of serum electrolytes are unaffected by hyperlipidemia. In this report we demonstrate that patients with idiopathic nephrotic syndrome with severe edema and true hyponatremia may have an increased rather than normal osmolal gap. We believe that this could be secondary to non-Na+ and non-K+ osmoles in response to plasma-volume contraction secondary to hypoalbuminemia. This observation has implications for management of severe edema in such patients, because fluid restriction could increase their risk for pre-renal failure. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/17485452/Serum_osmolal_gap_in_patients_with_idiopathic_nephrotic_syndrome_and_severe_edema_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=17485452 DB - PRIME DP - Unbound Medicine ER -