Inferior vena cava indices determine volume load in minimal lesion nephrotic syndrome

The pathogenesis of edema in nephrotic syndrome has not been entirely under stood. We investigated the value of the echographic parameters [inferior ve na cava index (IVCI), inferior vena cava collapsibility index (IVCCI), and left atrium diameter (LAD)] to determine the volume load in children with m inimal lesion nephrotic syndrome (mLNS). Twelve children with MLNS (seven b oys, five girls) were included in this study. The patients were classified into three different stages (stage A: edematous; stage B: 50% decrease in w eight gain; stage C: edema free) following measurement of their ideal weigh ts, The ideal weight of patients in stage A was increased 13 +/-7%. Serum t otal protein, albumin and urine sodium levels were found to be low in these patients. Plasma renin activity (PRA) and serum aldosterone levels in stag e A were significantly different from those of the control group (P<0.05). PRA and serum aldosterone levels were not different from those of the contr ol group in stage B (P>0.05). However, the increase in PRA was significant in stage C. Although a significant weight decrease was found in stages B an d C, it had no effect on IVCI, LAD, and cardiothoracic index. We consider I VCI, IVCCI, and LAD measurements by echocardiography (ECHO) to be easy and reliable clinical methods for assessing the intravascular volume load in pa tients with MLNS.