Renal sodium handling in children with nephrotic relapse: relation to hypovolaemic symptoms

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
J G Van de WalleH A Koomans

Abstract

We studied renal sodium handling during water diuresis in children in the early phase of relapse of minimal lesion nephrotic syndrome (MLNS). Findings were related to presence or absence of symptoms suggestive of hypovolaemia, and to neurohumoral factors, and were compared to results of similar studies in the same children in remission. Nine children (aged 7.8 +/- 3.1 years) presented with hypovolaemic symptoms, and 10 (7.4 +/- 4.3 years) without such symptoms. Both groups displayed severe proteinuria, hypoproteinaemia and oedema. Symptomatic patients showed tendency for a low glomerular filtration rate, and significantly impaired urine dilution, decreased fractional sodium and lithium excretions, and elevated diluting segment reabsorption [CH2O/(CH2O + CNa)] and sodium/potassium exchange [UK/(UK + UNa)]. In the non-symptomatic patients these parameters were normal. Plasma renin and aldosterone were significantly elevated in the symptomatic children, and strongly correlated with all parameters of tubule sodium reabsorption. Weaker associations were found for plasma noradrenaline and atrial natriuretic peptide. Vasopressin was also relatively high in the symptomatic group, but showed no association with impaired urine dilution. ...Continue Reading

Citations

Jul 20, 2007·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Ann RaesJohan Vande Walle
Mar 27, 2013·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Detlef Bockenhauer
Apr 29, 1998·The New England Journal of Medicine·S R Orth, E Ritz
Dec 3, 2004·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Lars PapeJochen H H Ehrich
Jan 17, 2013·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·René F AndersenSøren Rittig
Mar 1, 2006·BMC Pediatrics·Ann RaesJohan Vande Walle
Aug 31, 2013·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Melissa A CadnapaphornchaiRobert W Schrier
Nov 23, 2006·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Ann RaesJohan Vande Walle
Feb 26, 2004·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Johan Vande WalleRaymond Donckerwolcke
Jun 25, 2010·Pediatrics International : Official Journal of the Japan Pediatric Society·Metin Kaya GurgozeRuhan Dusunsel
Feb 6, 2015·Clinical and Experimental Nephrology·Yoshitsugu KakuUNKNOWN Japanese Society for Pediatric Nephrology
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Aug 21, 2015·American Journal of Physiology. Renal Physiology·Chia Wei TeohDamien Gerard Noone
Feb 15, 2019·Frontiers in Pediatrics·Brandon M LaneRasheed A Gbadegesin
Apr 24, 1999·Journal of the American Society of Nephrology : JASN·J G Vande WalleH A Koomans

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