Background and Objective: To assess the effectiveness and safety of oral amiloride for the treatment of
edema in pediatric patients with idiopathic nephrotic syndrome.
Methods: A randomized trial of amiloride vs hydrochlorthiazide was done in 34 patients. The mean age was
4.3±0.7 years old. After a 2 week washout of diuretic therapy, nephrotic children with edema were randomized
into two groups receiving amiloride vs hydrochlorthiazide. The effect of diuretics was assessed by the amount of
weight reduction and the measurement of urinary fractional excretion of sodium during the first three days of
diuretic therapy. The primary end point was the decrease in body weight.
Findings: Of 34 patients enrolled for this trial, 17 patients were in amiloride group and 17 patients in hydrochlorthiazide
group. The mean weight loss during the first three days of diuretic therapy was 1.3±0.65 kg in
amiloride group and 1.19±0.4 kg in hydrochlorthiazide group (PV=0.55). The mean of maximum urinary fractional
excretion of sodium during the first three days of diuretic therapy was 2.1±0.65% in amiloride group and
1.8±1% in hydrochlorthiazide group.
Conclusion: There was not any difference between amiloride and hydrochlorthiazide medications in reducing
weight and increasing urinary fractional excretion of sodium in children with nephrotic syndrome.