Introduction: The treatment of severe edema in a child with nephrotic syndrome is generally managed by furosemide. Hypoalbuminemia diminishes the amount of albumin-bound furosemide and diminishes the furosemide delivery to the ascending limb of the loop of henle and ultimately diminishes the diuretic effect.

Objectives: To compare the therapeutic outcome of albumin and furosemide combination (Intervention group) and furosemide alone (control group) in terms of clinical and biochemical parameters

Methods:  Open labeled Quasi-experimental study was conducted in department of pediatrics VSSIMSAR, Burla from October 2016 to September 2018 after institutional ethics committee approval .40 subjects were included as per predefined inclusion and exclusion criteria, out of which 20 subjects were placed in intervention group and 20 in control group alternatively by random allocation.

Results: Data expressed as mean ± standard deviation. P value <0.05 was considered to be significant. Body weight, abdominal circumference, serum sodium, serum potassium values decreased significantly after receiving respective drugs (at 1hr and 24 hr) as compared to pretreatment value (at 0hr) but the mean difference among both the groups from pretreatment value to 24 hrs after treatment was not statistically significant In both groups urine output increased  significantly after receiving respective drugs as compared to pretreatment and mean difference at 24hrs was found statistically significant. In (F) group serum Albumin decreased significantly at 24 hrs of post treatment as compared to baseline value. In (A+F) group Serum Albumin increased significantly at 24 hrs of post treatment as compared to baseline. In (F) group the mean percentage of inferior vena caval collapsibility index (IVCCI) remains same at 1hr and 24hrs of post treatment but in (A+F) group IVCCI decreased significantly at 1hr but returning to baseline value at 24hrs of post treatment.

Conclusion: The present study conclude that the add on effect of diuretics therapy when co-administrated albumin infusion priming is therapeutically better and equally safe than intravenous furosemide alone in management of severe edema in children with nephrotic syndrome.

Keywords: Nephrotic syndrome, edema, albumin, furosemide.

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K.Arun Kumar

PG Student, Department of Pediatrics, VSSIMSAR, Sambalpur, Odisha

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