Effectiveness of Furosemide Combined with Human Albumin Versus Furosemide Alone in the Management of Edema Among Pediatric Nephrotic Syndrome Patients: An Observational Study

Abstract

Introduction: Generalized edema is one of the major significant problems in nephrotic syndrome. The standard primary line of treatment for edema reduction is diuretics like Furosemide, and thiazides. Furosemide's effectiveness is hindered by hypoalbuminemia; hence co-administration of albumin may enhance therapeutic outcomes of Furosemide. The study aimed to evaluate the effectiveness of parenteral Furosemide alone and co-administered with human albumin in terms of diuretic and natriuretic effect in nephrotic children with edema. Methodology: The present hospital based observational study was conducted at a tertiary care facility, Jaipur from June 2019 to July 2020. We enrolled a total of 50 children with nephrotic syndrome and edema who were receiving two kinds of treatment. In the first group, children received intravenous Furosemide alone while in second group, 20% human albumin (1 gm/kg) along with intravenous Furosemide was given. Urine output, changes in weight and abdominal girth were noted at admission and 24 hours after treatment and laboratory parameters were also estimated. Results: There was a significant difference in mean weight loss, increase in urine output, decrease in abdominal girth, and in changes in levels of serum albumin between both the treatment groups. Non-significant difference was observed in blood urea, serum creatinine, sodium, and potassium between both the treatments. Conclusion: The co-administration of albumin and Furosemide is more effective than the administration of Furosemide alone inducing diuresis in patients with nephrotic syndrome.

Keywords

• Edema, Furosemide, Human albumin, Nephrotic syndrome, Urine output.