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Journal of the Korean Society of Pediatric Nephrology 2000;4(2): 102-110.
인알부민 투여가 스테로이드 반응성 신증후군의 임상경과에 미치는 영향
이수진, 정지아, 황수자, 이승주
1이화여자대학교 의과대학 소아과학교실
2이화여자대학교 의과대학 소아과학교실
3이화여자대학교 의과대학 소아과학교실
4이화여자대학교 의과대학 소아과학교실
The Effect of Human Albumin Infusion on the Clinical Course of Steroid Sensitive Nephrotic Syndrome
Soo Jin Lee, Ji A Jeong, Soo Ja Hwang, Seung Joo Lee
1Department of Pediatrics, College of Medicine, Ewha Womans University
2Department of Pediatrics, College of Medicine, Ewha Womans University
3Department of Pediatrics, College of Medicine, Ewha Womans University
4Department of Pediatrics, College of Medicine, Ewha Womans University
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ABSTRACT
Purpose : Intravenous infusion of albumin has been widely und to relieve severe nephrotic edema in spite of beneficial or harmful effects. The purpose of this study is to examine the harmful effect of albumin on the clinical course of steroid sensitive nephrotic syndrome(SSNS). Method : We prospectively randomized the patients with nephrotic syndrome(biopsy proven or clinically compatible to minimal change nephrotic syndrome) into the albumin group(20$%$ albumin 1 g/kg) or control group(5$%$ D/W) between March 1997 and September 1999 at Ewha University Mokdong Hospital. We compared the clinical course of the albumin group(n=13) with the control group(n=13).
Results : 1. The duration of steroid therapy until complete remission in the albumin group was significantly longer than the control group($13.7{pm}6.4;days;vs;7.5{pm}2.8;days$)(P<0.05). 2. The remission duration to the first relapse was significantly shorter in the albumin group ($94{pm}63.5$ days) than the control group($190{pm}106.4$ days)(P< 0.05). There was no significant difference in the relapse rate within 1 year after complete remission[77$%$ (10/13) vs 46$%$ (6/13)](P>0.05) and the relapse frequency per year($1.9{pm}0.8;vs;1.5{pm}0.5$) between the albumin and control groups. 3. Spot urine protein/creatinine ratio significantly increased in the albumin group at post-albumin 2, 4 days(P<0.05). There was no significant difference in the change of the daily percent weight loss, blood pressure, serum Na, K concentration between the albumin and control groups.
Conclusion : Albumin infusion in SSNS delayed the response to steroid and shortened the remission duration to the first relapse. Albumin should be carefully used in nephrotic edema.
Key words: Steroid sensitive nephrotic syndrome | Remission | Relapse
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