Salt-poor human albumin in management of nephrotic syndrome

Thirteen patients with the nephrotic syndrome were treated with a high-protein diet, a 0.5 g sodium intake (equivalent to 1.3 g sodium chloride), and frusemide in increasing dosage. One became oedema-free with frusemide 240 mg daily, three became oedema-free with frusemide 500 mg daily, and two required a combination of high-dose frusemide and spironolactone. In three there was an appreciable increase in the blood urea, one patient developed hyponatraemia, and in two there was no weight loss. In these six patients infusions of human salt-poor albumin produced a prompt diuresis, loss of weight, and correction of the abnormal biochemical findings. In the seventh severely oedematous patient combined albumin and diuretic therapy led to a loss of 27 kg in 14 days.