Serum osmolal gap in patients with idiopathic nephrotic syndrome and severe edema

被引:7
作者
Kapur, Gaurav [1 ]
Valentini, Rudolph P. [1 ]
Imam, Abubakr A. [1 ]
Jain, Amrish [1 ]
Mattoo, Tej K. [1 ]
机构
[1] Wayne State Univ, Div Nephrol & Hypertens, Childrens Hosp Michigan, Sch Med, Detroit, MI 48201 USA
关键词
nephrotic syndrome; osmolal gap; hyponatremia; pre-renal failure;
D O I
10.1542/peds.2006-2554
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Pseudohyponatremia in idiopathic nephrotic syndrome with severe edema is attributed to hyperlipidemia that results in displacement of a portion of water phase of plasma. Current methods of measurement of serum electrolytes are unaffected by hyperlipidemia. In this report we demonstrate that patients with idiopathic nephrotic syndrome with severe edema and true hyponatremia may have an increased rather than normal osmolal gap. We believe that this could be secondary to non-Na+ and non-K+ osmoles in response to plasma-volume contraction secondary to hypoalbuminemia. This observation has implications for management of severe edema in such patients, because fluid restriction could increase their risk for pre-renal failure.
引用
收藏
页码:E1404 / E1407
页数:4
相关论文
共 21 条
[1]  
ABRAHAM WT, 1997, EDEMATOUS DISORDERS, P72
[2]   DISPLACEMENT OF SERUM WATER BY THE LIPIDS OF HYPERLIPEMIC SERUM - NEW METHOD FOR THE RAPID DETERMINATION OF SERUM WATER [J].
ALBRINK, MJ ;
HALD, PM ;
MAN, EB ;
PETERS, JP .
JOURNAL OF CLINICAL INVESTIGATION, 1955, 34 (10) :1483-1488
[3]  
BOYD D R, 1970, Surgical Forum (Chicago), V21, P32
[4]  
Boyd D R, 1968, Am Surg, V34, P744
[5]   Absence of relation between hyponatraemia and hypothyroidism [J].
Croal, BL ;
Blake, AM ;
Johnston, J ;
Glen, ACA ;
OReilly, DSJ .
LANCET, 1997, 350 (9088) :1402-1402
[6]  
DORWART WV, 1975, CLIN CHEM, V21, P190
[7]   INTERRELATIONS BETWEEN SERUM SODIUM CONCENTRATION, SERUM OSMOLARITY AND TOTAL EXCHANGEABLE SODIUM, TOTAL EXCHANGEABLE POTASSIUM AND TOTAL BODY WATER [J].
EDELMAN, IS ;
LEIBMAN, J ;
OMEARA, MP ;
BIRKENFELD, LW .
JOURNAL OF CLINICAL INVESTIGATION, 1958, 37 (09) :1236-1256
[8]   Osmolality and osmolarity: Narrowing the terminology gap [J].
Erstad, BL .
PHARMACOTHERAPY, 2003, 23 (09) :1085-1086
[9]  
INABA H, 1987, LANCET, V1, P1331
[10]   Osmol gaps in the pediatric population [J].
McQuillen, KK ;
Anderson, AC .
ACADEMIC EMERGENCY MEDICINE, 1999, 6 (01) :27-30