Intestinal Loss of Plasma Protein is Associated with Hypoalbuminemia in Patients with Hemorrhagic Fever with Renal Syndrome.
- Author:
Young Ok KIM
1
;
Chul Woo YANG
;
Ho Cheol SONG
;
Sun Ae YOON
;
Yong Soo KIM
;
Suk Young KIM
;
Euy Jin CHOI
;
Yoon Sik CHANG
;
Byung Kee BANG
Author Information
1. Department of Internal Medicine, Medical College, The Catholic University of Korea, Seoul, Korea.
- Publication Type:Original Article
- MeSH:
Acute Kidney Injury;
Capillary Permeability;
Fever;
Hemorrhagic Fever with Renal Syndrome*;
Humans;
Hypoalbuminemia*;
Incidence;
Plasma*;
Proteinuria;
Renal Dialysis;
Serum Albumin;
Thrombocytopenia
- From:Korean Journal of Nephrology
1999;18(5):700-706
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: Hemorrhagic fever with renal syndrome(HFRS) is characterized by acute renal failure and increased vascular permeability. Hypoalbumi-nemia is frequently observed in the acute stage of HFRS, but its pathogenesis is not well known. In this study, we investigated intestinal loss of plasma protein in patients with HFRS. METHODS: First, we evaluated the incidence of proteinuria and measured the amount of urine protein in 20 patients during clinical course of HFRS. Second, GI loss of plasma protein was evaluated using Tc-human serum albumin(Tc-HSA) scan and fecal clearance of a l-antitrypsin(Cz). RESULTS: Seventeen(85%) of 20 patients demonstrated hypoalbuminemia(serum albumin level <3.5 g/dL) during admission and its lowest level was 3.0 +/- 0.3g/dL. Urine protein during admission was 1.9 +/- 1.3g/day and most of them showed negative con- version within 7days(7 6days). Tc-HSA scan revealed 65% positivity(13/20) in the acute stage and increased CAJ was observed 13 out of 20 patients (65%). In these patients, CAf in the recovery stage was significantly decreased compared to that in the acute stage(9.2 +/- 4.2ml/day vs 40.5>24.lml/day, p< 0.01). The mean serum albumin level in the patients with increased CAp was lower than that in the patients with normal CAy(2.80.1g/dL vs 3.4+0.2 g/dL, p<0.01). In the patients who had increased CA J', hypotensive episodes were more frequent, number of patients who needed hemodialysis was more, and thrombocytopenia was severer compared with the patients with normal CAp. But there was no difference in the amount of proteinuria between two groups. CONCLUSION: Our study suggests that intestinal loss of plasma protein is in part associated with hypoalbuminemia occurred in the acute stage of HFRS.
