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Nephrotic Syndrome: Oedema Formation and Its Treatment With Diuretics

Gupta, S; Pepper, RJ; Ashman, N; Walsh, SB; (2019) Nephrotic Syndrome: Oedema Formation and Its Treatment With Diuretics. Frontiers in Psychology , 9 , Article 1868. 10.3389/fphys.2018.01868. Green open access

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Abstract

Oedema is a defining element of the nephrotic syndrome. Its’ management varies considerably between clinicians, with no national or international clinical guidelines, and hence variable outcomes. Oedema may have serious sequelae such as immobility, skin breakdown and local or systemic infection. Treatment of nephrotic oedema is often of limited efficacy, with frequent side-effects and interactions with other pharmacotherapy. Here, we describe the current paradigms of oedema in nephrosis, including insights into emerging mechanisms such as the role of the abnormal activation of the epithelial sodium channel in the collecting duct. We then discuss the physiological basis for traditional and novel therapies for the treatment of nephrotic oedema. Despite being the cardinal symptom of nephrosis, few clinical studies guide clinicians to the rational use of therapy. This is reflected in the scarcity of publications in this field; it is time to undertake new clinical trials to direct clinical practice.

Type: Article
Title: Nephrotic Syndrome: Oedema Formation and Its Treatment With Diuretics
Open access status: An open access version is available from UCL Discovery
DOI: 10.3389/fphys.2018.01868
Publisher version: https://doi.org/10.3389/fphys.2018.01868
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
Keywords: Science & Technology, Life Sciences & Biomedicine, Physiology, nephrotic syndrome, diuretics, oedema, amiloride, epithelial sodium channel, EPITHELIAL SODIUM-CHANNEL, ATRIAL-NATRIURETIC-PEPTIDE, VASCULAR-PERMEABILITY FACTOR, NA+/K+-ATPASE ACTIVITY, COLLECTING DUCT, VOLUME EXPANSION, RISK-FACTORS, FUROSEMIDE, AMILORIDE, ENAC
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Renal Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10067115
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