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Albumin in Nephrotic Syndrome — RACP Paediatrics MCQ

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HardNephrologyAlbumin in Nephrotic SyndromeRACP Paediatrics

A 5-year-old with nephrotic syndrome develops periorbital and genital oedema with ascites. He has a blood pressure of 90/60 (low). His albumin is 12 g/L. What is the appropriate fluid management?

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Correct answer: D — IV 20% albumin infusion (0.5-1 g/kg) followed by IV furosemide

Symptomatic hypovolaemic nephrotic syndrome (low BP, tachycardia, poor perfusion, very low albumin) requires cautious IV albumin (20% albumin 0.5-1 g/kg over 2-4 hours) followed by IV furosemide to promote diuresis. Excessive fluid resuscitation without albumin can worsen oedema.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Nephrotic Syndrome