Page 333 - Abstract Book KONIKA 18

Nephrology

P-NEP-029
Relationship between Serum Albumin and Serum Calcium Level
in Children with Nephrotic Syndrome

Ivan Halim, Adrian Umboh, Valentine Umboh
Department of Child Health, Faculty of Medicine Universitas Sam Ratulangi/
Prof. Dr. R. D.Kandou Hospital, Manado, North Sulawesi, Indonesia

Abstract
Background Nephrotic syndrome is one of the most common glomerular disease that affect children
characterized by proteinuria, hypoalbuminemia, and oedema. One of the complications is hypocalcemia,
which can cause tetany, bone formation disorders, and metabolic bone disease. In proteinuria, medium-sized
protein-binding is also wasted. Objective To assess the relationship between serum albumin and serum
calcium level in children with nephrotic syndrome. Methods An analytical study with cross-sectional design
was applied to children with nephrotic syndrome between 1-18 years old and were taken by consecutive
admission who were treated at Child Health Department, Prof. dr. R. D. Kandou, Manado from April to
June 2021. Analysis was carried out using Pearson correlation and linear regression test. Results Thirty-
three children (25 boys and 8 girls) were included in this study, and the mean age was 11.78. The average
serum albumin level was 1.76±0.80 g/dL and serum calcium was 7.30±0.96 mg/dL. Pearson correlation test
between albumin and serum calcium levels was significant (P<0.05) with a correlation coefficient (r) 0.496.
The regression analysis result showed a positive linear relationship between albumin (x) and serum calcium
levels (y), with the equation: ỳ = 6.25 + 0.59x. Conclusion There is a moderately positive linear relationship
between serum albumin and serum calcium level in nephrotic syndrome children.
Keywords: nephrotic syndrome; serum albumin; serum calcium

P-NEP-030
Nephrogenic Ascites in Children with Routine Hemodialysis: A Case Report

Dewi Jumantan, Budyarini P. Sari, Kristia Hermawan
Departement of Child Health, Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada/
Dr. Sardjito General Hospital, Yogyakarta, Central Java, Indonesia

Abstract
Background Nephrogenic ascites is refractory and massive ascites in patients with end-stage kidney disease
(ESKD) underwent routine hemodialysis. The mechanism was still unclear. Diagnosis of nephrogenic
ascites must be established by exclusion. There is no epidemiology research in children has been reported.
Objective To report ESKD children with routine haemodialysis complicated by nephrogenic ascites.
Case A 16-year-old girl was diagnosed with ESKD secondary to nephrotic syndrome on hemodialysis
(HD) for 4 years, presented with progressively worsening abdominal distention within six months. She had
an episode of hypotension during HD and caused target ultrafiltration cannot fulfill. Upon admission, she
had shortness of breath and peripheral edema without any fever. She had stable hemodynamic, abdominal
examination revealed massive ascites. Ascitic fluid analysis revealed white cell count was 65 cells/mm3
with 85% mononuclear cells, protein of 5.85 g/dL, sugar of 54 mg/dL, lactate dehydrogenase of 267 U/L
and serum-ascites albumin gradient (SAAG) was 0.56 g/dL. Cultures and GenExpert of abdominal fluid
were negative. Abdominal ultrasound, abdominal computed tomography (CT), and echocardiography were
normal. She was diagnosed with nephrogenic ascites. Despite we treated the patient with more intensive
hemodialysis, large-volume paracentesis, and continuous ambulatory peritoneal dialysis (CAPD), there
were only minimal improvements in ascites reduction. She had severe bacterial and fungal infection those
as complication of multiple invasive procedures, which led to her death. Conclusion Nephrogenic ascites is
a rare condition. Once it happened, it would be difficult to be treated and has a poor prognosis.
Keywords: nephrogenic ascites; refractory ascites; children; end-stage kidney disease

KONIKA XVIII Abstract Book 285