DIURETIC TREATMENT OF NEPHROTIC SYNDROME

Massive proteinuria is responsible for the clinical aspect of nephroti c syndrome especially for the edematous state of the patients. ''Under fill''- and ''overflow''-mechanisms may contribute to edema formation. Edema resistent to diuretics is the main problem in symptomatic thera py of the nephrotic syndrome. Determination of fractional Na+-excretio n helps to identify these patients. The combination of different types of diuretics (segmental nephron blokkade) instead of high-dose monoth erapy may help to break the resistance to diuretics.