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Medline ® Abstract for Reference 33

of 'Pathophysiology and treatment of edema in patients with the nephrotic syndrome'

A critique of the overfill hypothesis of sodium and water retention in the nephrotic syndrome.
Schrier RW, Fassett RG
Kidney Int. 1998;53(5):1111.
Recent reviews have claimed that the majority of patients with the nephrotic syndrome have plasma volume expansion (that is, they are overfilled). Here we attempt to re-establish balance to the debate on body fluid volume status in nephrotic patients by: (a) discussing the conflicting literature on plasma volume measurements in the nephrotic syndrome; (b) providing alternate explanations for data purporting to support an overfill hypothesis in the nephrotic syndrome; (c) emphasizing secondary neurohumoral responses that support underfilling at least as frequently as overfilling; and (d) emphasizing the clinical importance of fluid assessment in the individual patient with the nephrotic syndrome particularly in relation to diuretic use.
Department of Medicine, University of Colorado School of Medicine, Denver, USA. Pat.Knox@UCHSC.edu