Kallash Mahmoud, Mahan John D
Division of Pediatric Nephrology, Nationwide Children's Hospital, 700 Children's Dr., Columbus, OH, 43205, USA.
The Ohio State University College of Medicine, Columbus, OH, USA.
Pediatr Nephrol. 2021 Jul;36(7):1719-1730. doi: 10.1007/s00467-020-04779-x. Epub 2020 Nov 20.
Edema is the abnormal accumulation of fluid in the interstitial compartment of tissues within the body. In nephrotic syndrome, edema is often seen in dependent areas such as the legs, but it can progress to cause significant accumulation in other areas leading to pulmonary edema, ascites, and/or anasarca. In this review, we focus on mechanisms and management of edema in children with nephrotic syndrome. We review the common mechanisms of edema, its burden in pediatric patients, and then present our approach and algorithm for management of edema in pediatric patients. The extensive body of experience accumulated over the last 5 decades means that there are many options, and clinicians may choose among these options based on their experience and careful monitoring of responses in individual patients.
水肿是指体内组织间质中液体的异常积聚。在肾病综合征中，水肿常出现在腿部等低垂部位，但也可能进展，导致其他部位出现大量积液，进而引发肺水肿、腹水和/或全身性水肿。在本综述中，我们重点关注肾病综合征患儿水肿的机制及管理。我们回顾了水肿的常见机制、其在儿科患者中的负担，然后介绍了我们对儿科患者水肿的管理方法和流程。过去50年积累的丰富经验意味着有多种选择，临床医生可根据自身经验及对个体患者反应的密切监测在这些选择中做出抉择。
