Acute Dehydration in Nephrotic Syndrome: A Case Report

Abstract

The management of acutely dehydrated children with relapsed nephrotic syndrome (NS) can be challenging when edema and intravascular volume depletion are present simultaneously. In that condition the excess in body fluid, typically associated with NS, may be inappropriately low, with regard to albumin level, and the excess in fluid is not promptly shifted into the vascular bed because of the low plasma protein concentration. This peculiar condition exposes the child to a greater risk of acute kidney injury (AKI) particularly if albumin infusion is provided. Here in a case of dehydration in ongoing NS is described in order to highlight the danger of infusing albumin when dehydration coexists. The present case report provides a framework for discussing an unusual and preventable pathophysiological mechanism of AKI related to the inappropriate administration of albumin infusion.