Relative polycythemia associated with minimal change disease.
- Author:
Jin Young KIM
1
;
Young Shin SHIN
;
Chan Ran YOU
;
Cheol Whee PARK
;
Young Jin CHOI
;
Yoon Sik CHANG
;
Byung Kee BANG
Author Information
1. Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea. jowoon@catholic.ac.kr
- Publication Type:Case Report
- Keywords:
Hypovolemic shock;
Polycythemia;
Nephrotic syndrome;
Minimal change
- MeSH:
Adult;
Capillaries;
Central Venous Pressure;
Child;
Diuretics;
Echocardiography;
Edema;
Glomerular Filtration Rate;
Humans;
Hypovolemia;
Nephrosis, Lipoid*;
Nephrotic Syndrome;
Polycythemia*;
Proteinuria;
Renal Circulation;
Shock
- From:Korean Journal of Medicine
2004;67(Suppl 3):S799-S803
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Hypovolemia and relative polycythemia is not an uncommon presentation in a child with nephrotic syndrome, but it is seldom mentioned in an adult. We experienced a case of hypovolemic shock and erythrocytosis in a patient with minimal change disease. Hypovolemia and polycythemia was corrected only after infusing isotonic fluid with albumin for 3 days. Hypovolemic shock is attributable to some of the following factors; suddenly decreased capillary oncotic pressure due to massive proteinuria, interstitial edema with tubular collapse, redistribution of renal blood flow, decreased glomerular filtration rate, and use of diuretics without albumin. In summary, 1) Relative polycythemia may occur as a result of hypovolemia in a patient with nephrotic syndrome but can be easily corrected by isotonic fluid and albumin. 2) An early detection of hypovolemia can be made by the measurement of central venous pressure, echocardiography, and the assessement of FeNa, U[k]/(U[Na]+U[K]). 3) Diuretics without albumin may result in transient developement of shock in patients with profound volume depletion.
