Nephrotic Syndrome


Hypovolaemia

Hypovolaemia is probably not as common as previously thought, in childhood nephrotic syndrome, but is important to recognise as it predisposes to acute renal failure and thrombotic complications.

Presenting features:

  • Abdominal pain
  • Anorexia
  • Vomiting
  • Tachycardia
  • Hyper- or normotension
  • Cool peripheries
  • Core-toe temperature difference of >3°C
  • Oliguria

Diagnosis supported by:

  • Increased haemoglobin concentration or haematocrit
  • Increased serum urea
  • Urinary sodium < 5 mmol/L (unreliable if diuretics given)
  • Fractional excretion of sodium < 1% (FENa = [Urine [Na] / Serum [Na]] x [Serum [creatinine] / Urine [creatinine]] x 100%

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