Abstract

Aim:

To assess the effectiveness and safety of oral amiloride for the treatment of edema in pediatric patients with idiopathic nephrotic syndrome.

Methods and subjects:

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 weeks 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 reductionand the measurement of urinary fractional excretion of sodium during the first three days of diuretic therapy.

Results:

34 patients were enrolled for this trial (17 patients 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.