An evaluation of ultrafiltration as treatment of diuretic-resistant oedema in nephrotic syndrome.

Plasma volume, plasma colloid osmotic pressure, creatinine clearance and sodium excretion were measured before and after ultrafiltration treatment in six patients with diuretic-resistant nephrotic syndrome. The mean total ultrafiltrate volume in two sessions on two successive days was 7460 ml, the mean ultrafiltration rate was 22.0 ml/min and the calculated plasma refilling rate was 19.9 ml/min. Plasma volume and creatinine clearance were unchanged and sodium excretion was reduced after treatment. A short-lasting drop in blood pressure was seen in 3 of the 12 treatment sessions. No other complications were noted. Ultrafiltration is a safe and useful alternative in the treatment of the few patients with massive oedema due to nephrotic syndrome not responding to conventional therapy.