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Role of aldosterone on the minimal change nephrotic syndrome in children.

Journal of the Korean Pediatric Society 1989;32(11):1526-1532.
Published online November 30, 1989.
Role of aldosterone on the minimal change nephrotic syndrome in children.
Soon Wha Kim, Myung Ik Lee, Don Hee Ahn
Department of Pediatrics, National Medical Center, Seoul, Korea
미소 변화 신증후군 환아에서의 혈청 Aldosterone치 변화에 관하여
김순화, 이명익, 안돈희
국립의료원 소아과
Received: 6 April 1989   • Accepted: 19 July 1989
We studied 11 cases of minimal change nephrotic syndrome randomly selected among 16 cases of minimal change nephrotic syndrome who were proved by kidney biopsy at department of pediatrics, National Medical Center during the period of January 1985 through December 1987. These patients were studied serially at 3 different stages in their clinical course. These were stages of edema formation, diuresis and remission, respectively. The results were summarized as follows: 1) In the edema-forming stage, all patients showed hypoalbuminemia of 1.42±0.23 gm/dl of mean serum albumin. Serum albumin was increased to 2.60 ±0.55 gm/dl in the stage of diuresis, and 4.01 ± 0.77 mg/dl in the stage of remission. 2) Urinary protein excretion was 6.52 ±4.66 gm/dl in the stage of edema, 0.55 ±0.66 gm/dl in the stage of diuresis, and urinary protein excretion was completely diminished in the stage of remission in all the patients. 3) Urinary sodium excretion was suppresed to 31.2±30.13 mEq while on 2—3 gm of daily allowance of sodium in the edema forming stage and exaggerated to 95.7 ±47.39 mEq of that in the diuresis. In the stage of remission, sodium was showed to be well balanced between it’s intake and output. 4) Glomerular filtration rate (GFR) expressed by creatinine clearance was 72.7 ±27 ±63 ml/min, 87.8± 19.5 ml/min and 82.3 ±20.29 ml/min in each stage respectively. 5) Plasma aldosterone elevated to 40.13 ±36.11 ng/dl in the edema forming stage and decreased to 10.05 ±8.54 ng/dl in the diuretic stages. In the stage of remission plasma aldosterone was 16. 78 ±9.08 ng/dl, showing significant difference between edema forming stage and diuretic stage. 6) The amount of 24 hour urinary sodium excretion had a inverse correlation with plasma aldosterone but showed no statistical significance between them. 7) The systolic blood pressure was 105.5±36.68 mmHg, 119.4±11.72 mmHg and 121.5±14.92 mmHg in each stage, and diastolic blood pressure was 69.1 ± 13.0 mmHg, 79. l±10.68 mmHg and 78.5 ±8.83 mmHg in each stage respectively.
Key Words: Minial change nephrotic syndrome, Plasma aldosterone, Urinary sodium excretion

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