Korean J Nephrol.  1999 Sep;18(5):700-706.

Intestinal Loss of Plasma Protein is Associated with Hypoalbuminemia in Patients with Hemorrhagic Fever with Renal Syndrome

• Kim YO
• Yang CW
• Song HC
• Yoon SA
• Kim YS
• Kim SY
• Choi EJ
• Chang YS
• Bang BK

Abstract

OBJECTIVE
Hemorrhagic fever with renal syndrome(HFRS) is characterized by acute renal failure and increased vascular permeability. Hypoalbumi-nemia is frequently observed in the acute stage of HFRS, but its pathogenesis is not well known. In this study, we investigated intestinal loss of plasma protein in patients with HFRS.
METHODS
First, we evaluated the incidence of proteinuria and measured the amount of urine protein in 20 patients during clinical course of HFRS. Second, GI loss of plasma protein was evaluated using Tc-human serum albumin(Tc-HSA) scan and fecal clearance of a l-antitrypsin(Cz).
RESULTS
Seventeen(85%) of 20 patients demonstrated hypoalbuminemia(serum albumin level <3.5 g/dL) during admission and its lowest level was 3.0 +/- 0.3g/dL. Urine protein during admission was 1.9 +/- 1.3g/day and most of them showed negative con- version within 7days(7 6days). Tc-HSA scan revealed 65% positivity(13/20) in the acute stage and increased CAJ was observed 13 out of 20 patients (65%). In these patients, CAf in the recovery stage was significantly decreased compared to that in the acute stage(9.2 +/- 4.2ml/day vs 40.5>24.lml/day, p< 0.01). The mean serum albumin level in the patients with increased CAp was lower than that in the patients with normal CAy(2.80.1g/dL vs 3.4+0.2 g/dL, p<0.01). In the patients who had increased CA J', hypotensive episodes were more frequent, number of patients who needed hemodialysis was more, and thrombocytopenia was severer compared with the patients with normal CAp. But there was no difference in the amount of proteinuria between two groups.
CONCLUSION
Our study suggests that intestinal loss of plasma protein is in part associated with hypoalbuminemia occurred in the acute stage of HFRS.

MeSH Terms

Acute Kidney Injury
Capillary Permeability
Fever
Hemorrhagic Fever with Renal Syndrome*
Humans
Hypoalbuminemia*
Incidence
Plasma*
Proteinuria
Renal Dialysis
Serum Albumin
Thrombocytopenia
Serum Albumin