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Management of edema in pediatric nephrotic syndrome – Underfill or overfill?

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Abstract

Purpose of review

To explore the mechanisms underlying edema formation in nephrotic syndrome. We highlight new methods of volume assessment and a stepwise approach to the management of edema.

Recent findings

New tools are available for intravascular volume assessment. New medications and modalities have been developed for the management of edema.

Summary

Edema is a major feature of nephrotic syndrome in children. It can be secondary to multiple mechanisms. Regardless of the causing mechanism, targeted management of edema should be guided by an adequate assessment of the intravascular volume. Urine studies e.g. urine sodium and potassium, as well as echocardiogram, can prove to be valuable tools. Besides diuretics, new agents and modalities are being developed for edema management including Aquaretics and isolated ultrafiltration.

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Authors and Affiliations

  1. Division of Nephrology and Hypertension, Nationwide Children’s Hospital, Columbus, OH, USA

    Ahmed Zeid, Tahagod Mohamed & Mahmoud Kallash

  2. The Kidney and Urinary Tract Center, Nationwide Children’s Hospital, Columbus, OH, USA

    Ahmed Zeid, Tahagod Mohamed & Mahmoud Kallash

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  1. Ahmed Zeid
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Zeid, A., Mohamed, T. & Kallash, M. Management of edema in pediatric nephrotic syndrome – Underfill or overfill?. Curr Pediatr Rep 10, 182–194 (2022). https://doi.org/10.1007/s40124-022-00270-3

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